MR Imaging of the Thoracic Inlet
Section snippets
Anatomic boundaries and definitions
The thoracic inlet is best described as a thin axial plane of tissue best defined by its osseous boundaries: the body of the first thoracic vertebra posteriorly and superiorly, the first pair of ribs and their costal cartilages bilaterally, and the superior border of the manubrium anteriorly and inferiorly.1 The inlet slopes anteroinferiorly, paralleling the obliquity of the first pair of ribs, so that the lung apices are located at the posterior aspect of the inlet, whereas the major
Fascial spaces of the infrahyoid neck and thoracic inlet
The spaces of the infrahyoid neck are anatomically demarcated by layers of the deep cervical fascia.2 Many of these spaces traverse the thoracic inlet into the mediastinum. Figs. 1A and 1B are axial diagrams of the lower neck (at the level of C7) and the thoracic inlet (at the level of T1). The boundaries and contents of spaces associated with the thoracic inlet are also summarized in Table 1. At the level of the thoracic inlet, the visceral space is divided into the pretracheal space
Structures traversing the thoracic inlet
Multiple structures traverse the thoracic inlet within these fascially defined spaces and are best described by organ system.
Summary
The thoracic inlet is really best considered as a plane connecting the neck and chest but through which traverses crucial digestive, respiratory, vascular, lymphatic, and neural structures. Endocrine tissues located in the lower neck (the thyroid and parathyroid glands) may also extend into the thoracic inlet.
Knowledge of the fascial spaces of the infrahyoid neck is helpful for understanding and predicting patterns of spread of tumor or infection through the thoracic inlet and into the
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