Clinical radiology
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Roentgenographic and clinical findings in a spectrum of malformations of the trachea and oesophagus are discussed. Five previously unreported patients representing four rare anomalies of tracheal agenesis, laryngotracheo-oesophageal cleft, oesophageal atresia with a tracheo-oesophageal (T-E) fistula to the proximal oesophageal pouch, and T-E fistula without oesophageal atresia (H-type fistula) are presented. ⋯ All of the patients were diagnosed roentgenographically. Since the incidence of associated abnormalities is high in babies with these anomalies, a generalised embryological defect must be a basic assumption in any theory to explain the development of T-E anomalies.
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Three hundred and seventeen cases which included 100 normal individuals have been studied for roentgen significance of the thoracic paraspinal line (TPL). The descending thoracic aorta greatly determines the course and configuration of the TPL. In a right-sided aorta, the TPL is seen on the right side as a mirror image of a left-sided TPL. ⋯ Perioesophageal spread of carcinoma of the oesophagus into the posterior mediastinum is indicated by changes in pleuro-oesophageal interface and TPL. Mediastinal lymphadenopathy in cases of testicular tumours may be detected by discovery of TPL deviation on frontal radiographs of the thoracic spine. In extradural masses such as granulomas, abscesses and metastatic deposits, the TPL shows a localised bulge corresponding to the clinical and myelographic level of spinal compression.