Sternal variations and anomalies in living individuals evaluated by MDCT: pictorial essay

This EPOS poster will be available online until July 20, 2020.

Congress:

ECR 2020

Poster Number:

C-11701

Type:

Educational Exhibit

Keywords:

Musculoskeletal, Anatomy, Musculoskeletal bone, Thorax, CT, CT-High Resolution, Computer Applications-3D, Education, Normal variants, Congenital, Education and training, Retrospective, Cross-sectional study, Performed at one institution

Authors:

K. Vatzia¹, E. Iosif², M. Fanariotis³, M. Vlychou¹, I. V. Fezoulidis¹, K. Vassiou⁴; ¹Larissa/GR, ²London/UK, ³Skien/NO, ⁴Nikaia - Larissa/GR

DOI:

10.26044/ecr2020/C-11701

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-11701

Fig. 1: 58-year-old man with suprasternal bones. Coronal MIP MPR image of sternum shows...

Fig. 2: 73-year-old man with suprasternal tubercles. Coronal MIP MPR image of sternum...

Fig. 3: 36-year-old woman with manubriosternal fusion. Coronal MIP MPR image of sternum...

Fig. 4: 61-year-old man with sternoxiphoidal fusion. Coronal MIP MPR image of sternum...

Learning objectives

To evaluate the anatomical variations of the sternum in a Greek adult population without sternal deformities, using 128-row MDCT scanner. To provide baseline statistical data about sternal variations.

Background

The sternum is an important anatomic structure, mainly due to its close adjacency to vital mediastinal organs [1-3]. The anatomical variations of the sternum are frequent, asymptomatic and detected incidentally at cross-sectional imaging [1,2]. With the increasing use of multidetector computed tomography (MDCT), the sternal variations can be identified more frequently [4]. Knowledge of these variations is important to avoid confusion with pathologic conditions or serious complications from adjacent organs, during interventions at the anterior chest wall, such as acupuncture practice and sternal marrow aspiration...

Findings and procedure details

Patient population At this retrospective study, 1150 patients who underwent MDCT scan of the chest, were evaluated. Medical records of the patients were available at the time the MDCT examination was performed. The study protocol was approved by the Institutional Review Board. Patients with gross sternal deformities, sternal fractures, sternal surgery and sternal masses or infections were excluded from the study. Therefore, MDCT images of 950 patients (573 men, 377 women; age range 18-95 years; mean age 63 years) were evaluated for detection of sternal...

Conclusion

MDCT provides excellent detection of sternal variations. Double-ended xiphoid process and single xiphoidal foramen were the most frequent sternal variations in our study. Radiologists’ familiarity with these variations is important for their discrimination from pathologies,misdiagnosis' prevention and potential complications' avoidance during sternal interventional procedures [4,11]. Whenever these variations are identified, this information should be included in the patient’s records [13].

Personal information and conflict of interest

K. Vatzia; Larissa/GR - nothing to disclose E. Iosif; London/UK - nothing to disclose M. Fanariotis; Skien/NO - nothing to disclose M. Vlychou;Larissa/GR - nothing to discloseI. V. Fezoulidis; Larissa/GR - nothing to disclose K. Vassiou; Nikaia - Larissa/GR - nothing to disclose

References

[1]. Yekeler E, Tunaci M, Tunaci A et al (2006) Frequency of sternal variations and anomalies evaluated by MDCT. Am J Roentgenol 186:956–960. [2]. Keats TE, Anderson MW (2001) Atlas of normal roentgen variants that may simulate disease. Mosby, Chicago. [3]. Gossner J (2013) Relationship of sternal foramina to vital structures of the chest: a computed tomography study. Anat Res Int 2013:780193. [4]. Duraikannu C, Noronha OV, Sundarrajan P. MDCT evaluation of sternal variations: Pictorial essay. Indian J Radiol Imaging 2016; 26:185-94 [5]. Fokin AA....