Kelly MacDonald1, Stephanie Mackenzie. 1. Department of Paediatric Radiology, Bristol Royal Hospital for Children, Bristol, UK. agatha@doctors.org.uk
Abstract
BACKGROUND: The thymus grows rapidly during fetal life and continues to grow during childhood. When a child undergoes a median sternotomy during cardiac surgery, most of the thymus is removed to gain access to the mediastinum. What happens to the residual thymic tissue in the long term? OBJECTIVE: To test the hypothesis that residual thymic tissue left after sternotomy regenerates into an identifiable thymus and is visible on MRI. MATERIALS AND METHODS: We retrospectively reviewed the cardiac MR images obtained over a 14-month period in all children under the age of 17 years who had undergone a median sternotomy (n=62) to establish the presence/absence of a thymus. We also reviewed the cardiac MR images obtained over the same time period in children who had never undergone open cardiac surgery (n=37). RESULTS: In the sternotomy group, 18 patients (29%) had an identifiable thymus on MR images, compared to 92% (n=34) in the nonsternotomy group. This difference was statistically significant. CONCLUSIONS: The majority of children in the study group did not have a visible thymus on MR images, which suggests that in these children any residual thymic tissue left postoperatively does not regenerate.
BACKGROUND: The thymus grows rapidly during fetal life and continues to grow during childhood. When a child undergoes a median sternotomy during cardiac surgery, most of the thymus is removed to gain access to the mediastinum. What happens to the residual thymic tissue in the long term? OBJECTIVE: To test the hypothesis that residual thymic tissue left after sternotomy regenerates into an identifiable thymus and is visible on MRI. MATERIALS AND METHODS: We retrospectively reviewed the cardiac MR images obtained over a 14-month period in all children under the age of 17 years who had undergone a median sternotomy (n=62) to establish the presence/absence of a thymus. We also reviewed the cardiac MR images obtained over the same time period in children who had never undergone open cardiac surgery (n=37). RESULTS: In the sternotomy group, 18 patients (29%) had an identifiable thymus on MR images, compared to 92% (n=34) in the nonsternotomy group. This difference was statistically significant. CONCLUSIONS: The majority of children in the study group did not have a visible thymus on MR images, which suggests that in these children any residual thymic tissue left postoperatively does not regenerate.
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