Role of the mediastinum as a part of the chest wall: analyzed by computed tomography.

Abstract

Using computed tomography (CT), geometrical changes in pulmonary structures in 4 human volunteers were analyzed. A series of parallel transaxial CT scans of the lung were obtained for each volunteer while he held his breath at maximal inspiration and maximal expiration. Changes in pulmonary structures were evaluated by comparing the maximal inspiration scans for each slice position. The longitudinal displacement of the lung volume was categorized as either a rib cage displacement or a diaphragm-abdominal displacement. The ratio of diaphragm-abdominal contribution to vital capacity was 0.49-0.65 for the volunteers. The thoracic volume displacement was categorized as either a mediastinal displacement or a rib cage displacement. The former was considerably larger than the latter. Since the rostral end of the mediastinum is fixed to the thoracic cage and the caudal end is fixed to the diaphragm, we conclude that the mediastinum-diaphragm boundary converts the axial force generated by the diaphragmatic excursion into radial force.