title: Revisiting thoracic surface anatomy in an adult population: A computed tomography evaluation of vertebral level.
abstract: To compare key thoracic anatomical surface landmarks between healthy and patient adult populations using Computed Tomography (CT). Sixteen slice CT images of 250 age and gender matched healthy individuals and 99 patients with lung parenchymal disease were analyzed to determine the relationship of 17 thoracic structures and their vertebral levels using a 32-bit Radiant DICOM viewer. The structures studied were: aortic hiatus, azygos vein, brachiocephalic artery, gastroesophageal junction (GEJ), left and right common carotid arteries, left and right subclavian arteries, pulmonary trunk bifurcation, superior vena cava junction with the right atrium, carina, cardiac apex, manubriosternal junction, xiphisternal joint, inferior vena cava (IVC) crossing the diaphragm, aortic arch and junction of brachiocephalic veins. The surface anatomy of all structures varied among individuals with no significant effect of age. Binary logistic regression analysis showed a significant association between individual health status and vertebral level for brachiocephalic artery (P = 0.049), GEJ (P = 0.020), right common carotid (P = 0.009) and subclavian arteries (P = 0.009), pulmonary trunk bifurcation (P = 0.049), carina (P = 0.004), and IVC crossing the diaphragm (P = 0.025). These observations differ from those reported in a healthy white Caucasian population and from the vertebral levels of the IVC, esophagus, and aorta crossing the diaphragm in an Iranian population. The differences observed in this study provide insight into the effect of lung pathology on specific thoracic structures and their vertebral levels. Further studies are needed to determine whether these are general changes or pathology-specific. Clin. Anat. 30:227-236, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Centre for Anatomy and Human Identification, University of Dundee, Scotland, United Kingdom.|North West School of Medicine, Hayatabad Peshawar, Khyber Pakhtunkhwa, 25000, Pakistan.
authors.forename: Masroor
authors.initials: M
authors.lastname: Badshah
authors.affiliation: Centre for Anatomy and Human Identification, University of Dundee, Scotland, United Kingdom.
authors.forename: Roger
authors.initials: R
authors.lastname: Soames
authors.affiliation: Department of Biochemistry, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, 25000, Pakistan.
authors.forename: Muhammad Jaffar
authors.initials: MJ
authors.lastname: Khan
authors.affiliation: Department of Surgery, Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa, 25000, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Department of Radiology, As Suwaidi Hospital, Shar-e-Hamza bin mutalib, Az zahra, Riyadh, Saudi Arabia.
authors.forename: Adnan
authors.initials: A
authors.lastname: Khan
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks; D063405:Anatomic Variation; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012016:Reference Values; D013909:Thorax / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: CT scans; cross-sectional anatomy; ethnic group; surface anatomy