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DOI: 10.1148/rg.271065073
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Lines and Stripes: Where Did They Go? —From Conventional Radiography to CT1

Jerry M. Gibbs, MD, Chitra A. Chandrasekhar, MBBS, Emma C. Ferguson, MD and Sandra A. A. Oldham, MD

1 From the Department of Diagnostic and Interventional Imaging, University of Texas Medical School at Houston, 6431 Fannin St, MSB 2.026, Houston, TX 77030. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received April 20, 2006; revision requested May 22 and received June 26; accepted June 28. All authors have no financial relationships to disclose.

Figure 1
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  		Figure 1a.  Illustration (a) and frontal chest radiograph (b) show a normal anterior junction line (black lines in a, arrows in b) coursing obliquely from the upper right to the lower left over the superior two-thirds of the sternum.

 

Figure 1
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  		Figure 1b.  Illustration (a) and frontal chest radiograph (b) show a normal anterior junction line (black lines in a, arrows in b) coursing obliquely from the upper right to the lower left over the superior two-thirds of the sternum.

 

Figure 2
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  		Figure 2.  CT scan demonstrates a normal anterior junction line (arrow) formed by the apposition of the visceral and parietal pleura of the lungs with intervening mediastinal fat.

 

Figure 3
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  		Figure 3a.  Abnormal-appearing anterior junction line in a patient who had undergone a right middle lobectomy. (a) Frontal chest radiograph shows the anterior junction line (arrows) displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm. (b) CT scan helps confirm rightward displacement of the anterior junction line (arrow) with volume loss in the right lung.

 

Figure 3
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  		Figure 3b.  Abnormal-appearing anterior junction line in a patient who had undergone a right middle lobectomy. (a) Frontal chest radiograph shows the anterior junction line (arrows) displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm. (b) CT scan helps confirm rightward displacement of the anterior junction line (arrow) with volume loss in the right lung.

 

Figure 4
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  		Figure 4a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal posterior junction line (black lines in a, arrows in b) as a straight line projecting through the trachea and extending above the clavicles.

 

Figure 4
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  		Figure 4b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal posterior junction line (black lines in a, arrows in b) as a straight line projecting through the trachea and extending above the clavicles.

 

Figure 5
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  		Figure 5.  CT scan demonstrates a normal posterior junction line (arrow), which lies posterior to the esophagus and is formed by the apposition of the visceral and parietal pleura of the lungs anterior to the thoracic vertebrae.

 

Figure 6
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  		Figure 6a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal right paratracheal stripe (black line in a, arrows in b).

 

Figure 6
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  		Figure 6b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal right paratracheal stripe (black line in a, arrows in b).

 

Figure 7
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  		Figure 7.  CT scan shows that the right paratracheal stripe (arrow) is formed by air within the right upper lobe and trachea outlining the right lateral tracheal wall, right upper lobe pleura, and intervening soft tissues.

 

Figure 8
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  		Figure 8a.  Abnormal right paratracheal stripe caused by a large ectopic parathyroid adenoma in a 52-year-old man. (a) Frontal chest radiograph demonstrates widening of the right paratracheal stripe (arrow). (b) CT scan helps confirm a large right paratracheal mass (arrow) with diffuse osteopenia from primary hyperparathyroidism.

 

Figure 8
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  		Figure 8b.  Abnormal right paratracheal stripe caused by a large ectopic parathyroid adenoma in a 52-year-old man. (a) Frontal chest radiograph demonstrates widening of the right paratracheal stripe (arrow). (b) CT scan helps confirm a large right paratracheal mass (arrow) with diffuse osteopenia from primary hyperparathyroidism.

 

Figure 9
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  		Figure 9a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal left paratracheal stripe (black line in a, arrows in b) extending from the aortic arch to join with the reflection from the left subclavian artery superiorly.

 

Figure 9
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  		Figure 9b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal left paratracheal stripe (black line in a, arrows in b) extending from the aortic arch to join with the reflection from the left subclavian artery superiorly.

 

Figure 10
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  		Figure 10a.  Abnormal-appearing left paratracheal stripe in a 47-year-old patient with metastatic thyroid carcinoma. (a) Frontal chest radiograph demonstrates widening of the left paratracheal stripe (arrows) with mass effect on the trachea. (b) CT scan reveals a large thyroid mass (arrow) and associated supraclavicular lymphadenopathy.

 

Figure 10
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  		Figure 10b.  Abnormal-appearing left paratracheal stripe in a 47-year-old patient with metastatic thyroid carcinoma. (a) Frontal chest radiograph demonstrates widening of the left paratracheal stripe (arrows) with mass effect on the trachea. (b) CT scan reveals a large thyroid mass (arrow) and associated supraclavicular lymphadenopathy.

 

Figure 11
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  		Figure 11a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal aortic-pulmonary stripe (black line in a, arrows in b) as a straight interface crossing the aortic arch and the main pulmonary artery.

 

Figure 11
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  		Figure 11b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal aortic-pulmonary stripe (black line in a, arrows in b) as a straight interface crossing the aortic arch and the main pulmonary artery.

 

Figure 12
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  		Figure 12.  CT scan shows a normal aortic-pulmonary stripe (arrows) formed by the anterior left lung contacting and tangentially reflecting over the mediastinal fat antero-lateral to the left pulmonary artery and aortic arch.

 

Figure 13
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  		Figure 13a.  Abnormal-appearing aortic-pulmonary stripe in a 42-year-old patient with lymphoma. (a) Frontal chest radiograph demonstrates abnormal contour of the aortic-pulmonary stripe (arrows). (b) CT scan shows anterior mediastinal lymphadenopathy (arrows) within the prevascular space.

 

Figure 13
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  		Figure 13b.  Abnormal-appearing aortic-pulmonary stripe in a 42-year-old patient with lymphoma. (a) Frontal chest radiograph demonstrates abnormal contour of the aortic-pulmonary stripe (arrows). (b) CT scan shows anterior mediastinal lymphadenopathy (arrows) within the prevascular space.

 

Figure 14
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  		Figure 14.  Frontal chest radiograph demonstrates a normal AP window as a shallow concave interface (*) between the aorta and the pulmonary artery. Note the normal aortic-pulmonary stripe (arrows) and its relation to the AP window.

 

Figure 15
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  		Figure 15.  CT scan shows the normal AP window (*). The concave interface seen in Figure 14 actually represents the lateral border (arrow) of the AP window formed by the left lung and pleura contacting the aortic arch and extending to the pulmonary artery.

 

Figure 16
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  		Figure 16a.  Abnormal-appearing AP window in a 64-year-old patient with bronchogenic carcinoma. (a) Frontal chest radiograph demonstrates an abnormal bulge in the AP window (arrow). Thickening of the right paratracheal stripe (*) is also noted, along with left lower lobe consolidation and left pleural effusion. (b) CT scan shows a significant soft-tissue mass within the AP window and subcarinal space, a finding that is compatible with metastatic lymphadenopathy. Lymphadenopathy in the paratracheal region was also noted, accounting for the thickened right paratracheal stripe.

 

Figure 16
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  		Figure 16b.  Abnormal-appearing AP window in a 64-year-old patient with bronchogenic carcinoma. (a) Frontal chest radiograph demonstrates an abnormal bulge in the AP window (arrow). Thickening of the right paratracheal stripe (*) is also noted, along with left lower lobe consolidation and left pleural effusion. (b) CT scan shows a significant soft-tissue mass within the AP window and subcarinal space, a finding that is compatible with metastatic lymphadenopathy. Lymphadenopathy in the paratracheal region was also noted, accounting for the thickened right paratracheal stripe.

 

Figure 17
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  		Figure 17a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal right paraspinal line (black line in a, arrows in b) as a thin straight line extending lateral to the thoracic spine.

 

Figure 17
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  		Figure 17b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal right paraspinal line (black line in a, arrows in b) as a thin straight line extending lateral to the thoracic spine.

 

Figure 18
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  		Figure 18.  CT scan shows normal right and left paraspinal lines (arrows) formed by the lungs and pleura contacting the posterior mediastinal soft tissues.

 

Figure 19
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  		Figure 19a.  Abnormal-appearing right paraspinal line in a 27-year-old patient who had sustained traumatic injury. (a) Frontal chest radiograph demonstrates an abnormal bulge in the right paraspinal line inferiorly (arrows). (b) CT scan reveals a large mediastinal hematoma (arrow) from multiple right-sided transverse process fractures of the thoracic spine and an associated right hemothorax.

 

Figure 19
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  		Figure 19b.  Abnormal-appearing right paraspinal line in a 27-year-old patient who had sustained traumatic injury. (a) Frontal chest radiograph demonstrates an abnormal bulge in the right paraspinal line inferiorly (arrows). (b) CT scan reveals a large mediastinal hematoma (arrow) from multiple right-sided transverse process fractures of the thoracic spine and an associated right hemothorax.

 

Figure 20
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  		Figure 20a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal left paraspinal line (black line in a, arrows in b) as a thin straight line extending from the aortic arch to the diaphragm. The normal left paraspinal line typically lies medial to the lateral wall of the descending thoracic aorta.

 

Figure 20
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  		Figure 20b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal left paraspinal line (black line in a, arrows in b) as a thin straight line extending from the aortic arch to the diaphragm. The normal left paraspinal line typically lies medial to the lateral wall of the descending thoracic aorta.

 

Figure 21
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  		Figure 21a.  Abnormal-appearing left paraspinal line in a 52-year-old patient with liver cirrhosis and esophageal varices. (a) Frontal chest radiograph reveals a focal lateral bulge in the left paraspinal line (arrow). (b) CT scan shows extensive esophageal varices (arrow), which are responsible for the abnormal contour of the left paraspinal line.

 

Figure 21
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  		Figure 21b.  Abnormal-appearing left paraspinal line in a 52-year-old patient with liver cirrhosis and esophageal varices. (a) Frontal chest radiograph reveals a focal lateral bulge in the left paraspinal line (arrow). (b) CT scan shows extensive esophageal varices (arrow), which are responsible for the abnormal contour of the left paraspinal line.

 

Figure 22
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  		Figure 22.  Lateral chest radiograph demonstrates a normal posterior tracheal stripe (arrows) as a thin vertical stripe posterior to the trachea.

 

Figure 23
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  		Figure 23.  CT scan reveals that the posterior tracheal stripe (arrow) is formed by air within the trachea and right lung outlining the posterior tracheal wall and intervening soft tissues.

 

Figure 24
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  		Figure 24a.  Abnormal posterior tracheal stripe in a 49-year-old patient with achalasia. (a) Lateral chest radiograph shows widening of the posterior tracheal stripe (arrows). (b) CT scan demonstrates a dilated esophagus (arrow) filled with food and contrast material.

 

Figure 24
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  		Figure 24b.  Abnormal posterior tracheal stripe in a 49-year-old patient with achalasia. (a) Lateral chest radiograph shows widening of the posterior tracheal stripe (arrows). (b) CT scan demonstrates a dilated esophagus (arrow) filled with food and contrast material.

 

Figure 25
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  		Figure 25a.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal azygoesophageal recess (black line in a, arrows in b) with mild leftward convexity superiorly and a straight edge inferiorly.

 

Figure 25
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  		Figure 25b.  Illustration (a) and frontal chest radiograph (b) demonstrate a normal azygoesophageal recess (black line in a, arrows in b) with mild leftward convexity superiorly and a straight edge inferiorly.

 

Figure 26
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  		Figure 26.  CT scan shows that the azygoesophageal recess (arrow) is an interface formed by the right lower lobe outlining the mediastinum adjacent to the esophagus and azygos vein.

 

Figure 27
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  		Figure 27a.  Abnormal azygoesophageal recess in a patient with a hiatal hernia. (a) On a frontal chest radiograph, the distal third of the azygoesophageal recess demonstrates an abnormal contour and right lateral convexity (arrows). (b) CT scan shows a large hiatal hernia (arrow) that causes a rightward bulge of the distal azygoesophageal recess.

 

Figure 27
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  		Figure 27b.  Abnormal azygoesophageal recess in a patient with a hiatal hernia. (a) On a frontal chest radiograph, the distal third of the azygoesophageal recess demonstrates an abnormal contour and right lateral convexity (arrows). (b) CT scan shows a large hiatal hernia (arrow) that causes a rightward bulge of the distal azygoesophageal recess.

 

Figure 28
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  		Figure 28.  Frontal chest radiograph demonstrates the normal posterior wall of the bronchus intermedius (arrows) as a thin vertical stripe that projects through the radiolucent area created by the left upper lobe bronchus.

 

Figure 29
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  		Figure 29.  CT scan reveals that the stripe representing the posterior wall of the bronchus intermedius (arrow) is formed by lung within the azygoesophageal recess outlining this posterior wall.

 

Figure 30
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  		Figure 30.  Abnormal posterior wall of the bronchus intermedius in a 55-year-old patient with pulmonary edema. Lateral chest radiograph demonstrates diffuse bandlike thickening of the posterior wall of the bronchus intermedius (arrows).

 




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