A detailed understanding of the structures that make up the normal contours of the cardiomediastinum on chest radiography is essential if abnormalities are to be detected.
Frontal view (PA / AP)
Right cardiomediastinal contour
From superior to inferior:
* right paratracheal stripe
o seen in two thirds of normal films 1
o made up of right brachiocephalic vein and SVC
* arch of the azygous vein
* ascending aorta in older individuals often projects to the right of the SVC
* superior vena cava (SVC)
* right atrium
* inferior vena cava (IVC)
Left cardiomediastinal contour
From superior to inferior:
* left paratracheal stripe
o made up of left common carotid artery, left subclavian artery and the left jugular vein
* aortic arch +/- aortic nipple (superior intercostal vein)
* pulmonary artery
* auricle of left atrium
* left ventricle
Lateral view
Anterior cardiomediastinal contour
From superior to inferior:
* superior mediastinum
o great vessels
o thymus
* ascending aorta
* right ventricular outflow track
* right ventricle
Posterior cardiomediastinal contour
From superior to inferior:
* left atrium and pulmonary veins
* right atrium
* inferior vena cava
Cardiomediastinal outlines - PA CXR
Cardiomediastinal outlines - Lateral CXR
Article Author : Dr Frank Gaillard, Radiopaedia
References
* 1. Collins Jannette and Eric J. Stern. Chest radiology. Lippincott Williams & Wilkins, 2007. ISBN: 0781763142, 9780781763141.
* 2. Haller Jack Oliver, Thomas L. Slovis and Aparna Joshi. Pediatric radiology. Birkhäuser, 2005. ISBN: 3540213546, 9783540213543.
