Multidetector computed tomography (MDCT) estimation of prevalence and anatomic characteristics of the sternal body foramen in the population of central Serbia

Maja Vulović; Ivana Živanović-Mačužić; Dejan Jeremić; Nela Đonović; Aleksandar Radunović; Milan Jovanović; Bojan Milošević; Zoran Aleksić; Ivana Stanković; Radiša Vojinović

doi:10.2298/VSP170321084V

Maja Vulović University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Anatomy
Ivana Živanović-Mačužić University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Anatomy
Dejan Jeremić University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Anatomy
Nela Đonović University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Hygiene and ecology
Aleksandar Radunović Clinic for Orthopedic Surgery, Military Medical Academy, Belgrade, Serbia
Milan Jovanović Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia
Bojan Milošević University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Surgery
Zoran Aleksić Clinic for General and Abdominal Surgery, of University Clinical Center of Republic of Srpska, Bosnia and Herzegovina
Ivana Stanković Ambulance Brigade of Guards, Belgrade, Serbia
Radiša Vojinović University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Radiology

DOI: https://doi.org/10.2298/VSP170321084V

Keywords: sternum, musculoskeletal abnormalities, multidetector computed tomography, prevalence, sternotomy, risk assessment, serbia

Abstract

Abstract

Background/Aim. The most frequent form of sternal defects is a single foramen, usually located at the distal half of the sternal body, with prevalence that varies among different ethnic populations. Clinical importance of these defects arises from various diagnostic and therapeutic sternal treatments and close location of heart, lungs and other vital organs of the chest cavity. The aim of this study was to determine the prevalence and morphometric characteristics of the sternal midline foramen in the population of central Serbia. Methods. The multidetector computed tomography (MDCT) chest images of 422 patients of both genders were analyzed. The radiological imaging was performed on 64-slice MDCT scanner (Aquilion 64, Toshiba, Japan). All scans were performed in the axial plane, with subsequent multiplanar reconstruction (MPR). Due to the angulation of the sternal body coronal curved-planar, the images were obtained in order to show the whole length of the sternum and the vertical diameter of the sternal foramen. The measurements were done using the commercially available software (Imaging Software ver. 4.1.14.0, Vital-Images). Results. The solitary foramen, located in the distal segment of the sternal body, was detected in 24 patients, representing 5.9% of the observed population with slightly higher prevalence in males. The average size of foramen was 3.9 × 4.2 mm. The mean distance from the skin was 12.7 ± 3.3 mm, the distance from skin to pericardium was on average 37.3 ± 8.2 mm, while the average distance from skin to pleura was 25 ± 5.9 mm. The average depth of foramen 8.7 ± 2 mm, while the mean distance from the posterior surface of foramen to pericardium was 12.7 ± 9.1 mm. Conclusion. The results presented in this paper confirmed the prevalence of 5.9% regarding the midline sternal foramen in the observed population. Serious complications of the sternal puncture could be prevented by prior MDCT imaging.

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