Pektus karinatum

Özet

Pektus karinatum, sternum ve kostokondral bileşkelerin anteriora doğru belirginleştiği gelişimsel ön göğüs duvarı deformitesidir; çıkıntı simetrik veya tek tarafı baskın olabilir. Pektus karinatum tanısı fizik muayeneyle konabilir; eşlik eden iskelet deformitelerinden şüphelenildiğinde ek incelemeler, BT ise bazı olgularda cerrahi planlama için yararlı olabilir. Sagittal BT rekonstrüksiyonları sternal gövde eğriliğinin değerlendirilmesinde kullanılabilir. Pektus karinatumda sternum dışa, pektus ekskavatumda içe yer değiştirir; bu yön farkı iki deformitenin morfolojik ayrımını sağlar.

Faz ve pencere

Kontrastsız tanısal

Kesitsel görüntüleme, pektus karinatumda tutulan yapıları ve komşu yapıların yer değiştirme ya da deformite derecesini değerlendirmeye yardımcı olabilir.

Önerilen pencereler: Kemik (G 1800 / M 400), Yumuşak doku (G 400 / M 40).

BT bulguları

• Sternal gövdenin ön göğüs duvarı düzlemine göre anteriora konveks çıkıntı yapması.
• Kostal kıkırdaklar da pektus karinatum deformitesine katılabilir.
• Çıkıntının gövde boyunca orta hatta olması veya bir hemitoraksta daha belirgin asimetri göstermesi.
• Chondrogladiolar tipte sternumdaki belirgin açılanma sternal gövde düzeyindedir.
• Chondromanubrial tipte sternumdaki belirgin açılanma daha üstte, manubrium düzeyindedir.
• Sternumda rotasyon, kısa-geniş sternal gövde veya pektus arcuatum gibi farklı morfolojiyle örtüşen kontur değişikliği.
• Eşlik eden skolyoz, kostal asimetri veya başka konjenital göğüs duvarı varyantının eş zamanlı görünümü.

Ölçütler ve sınıflamalar

Chondrogladiolar

Sternal gövde (gladiolus) ve komşu kostokondral kıkırdakların anterior çıkıntısı; asimetrik olabilir.

Chondromanubrial

Manubrium ve üst sternal bölümün çıkıntı yaptığı morfolojik tip.

Normalde

Normal sternal gövde ön göğüs duvarında düzgün bir kontur izler; sternum ile kostokondral bileşkelerde öne doğru fokal ya da yaygın tepe oluşmaz. Sagittal BT'de sternal gövde eğriliğini değerlendirirken normal kontrollerde daha sık görülen kademeli dikey eğri ve anterior düz seyir paternleriyle karşılaştır.

Ayırıcı tanı

Pektus ekskavatum

sternum içe doğru yer değiştirerek ön göğüs duvarında çökme oluşturur.

Pektus arcuatum

kısa, kalın ve geniş, segmentlere ayrılmamış sternum ile normal manubriosternal bileşke düzeyinde belirgin posterior açılanma görülebilir.

Sternal tümör veya kemik lezyonu

Kesitsel görüntüleme, anatomik deformiteyi neoplaziden ayırmaya yardımcı olabilir.

İyileşmiş sternal kırık

travmatik kökenli kemik yaralanmaları arasında yer alır ve farklı radyolojik özellikler gösterir.

Skolyoz pektus deformitelerine eşlik edebilir; pektus deformitesi olan hastalarda skolyoz birlikteliği bildirilmiştir.

Tuzaklar

• Çift boyutlu görüntülerde sternumun konumu yanıltıcı olabilir; multiplanar rekonstrüksiyonda sagittal planda sternal çıkıntı doğrulanmalıdır.
• Pektus karinatum tanısı fizik muayeneyle konabilir ve deformite ek görüntüleme olmadan karakterize edilebilir; BT ek bilgi sağlamayabilir ve radyasyon içerir.

Kendini dene

1. Sternumun öne doğru yer değiştirdiği pektus deformitesi hangisidir?

   • Pektus karinatum
   • Pektus ekskavatum
   • Skolyoz
   • Pektus arcuatum
   Cevabı göster

   Pektus karinatum. Pektus karinatumda sternum dışa, pektus ekskavatumda içe yer değiştirir.

2. Pektus karinatumda sternal açılanmanın manubrium düzeyinde olduğu morfolojik tip hangisidir?

   • Chondromanubrial
   • Chondrogladiolar
   • Pektus ekskavatum
   • Pektus arcuatum
   Cevabı göster

   Chondromanubrial. Chondromanubrial tipte sternal açılanma üstte, manubrium düzeyindedir.

İlgili konular

• Pektus ekskavatum
• Sternumun normal varyantları

Kaynaklar

Bu sayfadaki 34 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 18 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.