title: A reappraisal of adult thoracic and abdominal surface anatomy via CT scan in Chinese population.
abstract: Accurate surface anatomy is essential for safe clinical practice. There are numerous inconsistencies in clinically important surface markings among and within contemporary anatomical reference texts. The aim of this study was to investigate key thoracic and abdominal surface anatomy landmarks in living Chinese adults using computed tomography (CT). A total of 100 thoracic and 100 abdominal CT scans were examined. Our results indicated that the following key surface landmarks differed from current commonly-accepted descriptions: the positions of the tracheal bifurcation, azygos vein termination, and pulmonary trunk bifurcation (all below the plane of the sternal angle at vertebral level T5-T6 in most individuals); the superior vena cava formation and junction with the right atrium (most often behind the 1st and 4th intercostal spaces, respectively); and the level at which the inferior vena cava and esophagus traverse the diaphragm (T10 and T11, respectively). The renal arteries were most commonly at L1; the midpoint of the renal hila was most frequently at L2; the 11th rib was posterior to the left kidney in only 29% of scans; and the spleen was most frequently located between the 10th and 12th ribs. A number of significant sex- and age-related differences were noted. The Chinese population was also compared with western populations on the basis of published reports. Reappraisal of surface anatomy using modern imaging tools in vivo will provide both quantitative and qualitative evidence to facilitate the clinical application of these key surface landmarks.
authors.affiliation: Department of Anatomy, Histology and Embryology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Shen
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Bai-Yan
authors.initials: BY
authors.lastname: Su
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Jing-Juan
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Gu-Muyang
authors.initials: GM
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Hua-Dan
authors.initials: HD
authors.lastname: Xue
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Zheng-Yu
authors.initials: ZY
authors.lastname: Jin
authors.affiliation: Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: S Ali
authors.initials: SA
authors.lastname: Mirjalili
authors.affiliation: Department of Anatomy, Histology and Embryology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ma
mesh_terms: D000005:Abdomen / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D044466:Asian People; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013909:Thorax / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: central veins; diaphragm; kidney; lung; spleen; surface anatomy;  sternal angle