Evaluation of postnatal development and variations of sternum using multi-detector computed tomography

Abstract

ORIGINAL ARTICLE PURPOSE We aimed to evaluate the postnatal development and the maturation of the sternum and sternal variations using multidetector computed tomography (MDCT). Additionally, we aimed to examine the roles of gender and age in sternal development. MATERIALS AND METHODSTwo hundred and fifty patients who underwent thorax MDCT examinations were evaluated for sternal development and variations. Coronal curved planar reconstruction and maximum intensity projection images were used to better assess the ossification centers in the manubrium and the body of the sternum. Multiplanar images were used to accurately measure the thickness and the sagittal dimension of the manubrium, the sagittal dimension of the body, and the total sagittal dimension of the sternum in the sagittal plane. RESULTSNo significant differences in the manubrium measurements were observed between the genders. The thickness and sagittal dimension of the manubrium, sagittal dimension of the body, and total sagittal dimension of the sternum in the sagittal plane were significantly different between the age groups. We evaluated the ossification centers; shape and developmental variations in the manubrium and body; direction, calcification, and termination of the xiphoid process; developmental variations in the xiphoid process; and manubriosternal and sternoxiphoidal fusion. Significant variations were observed from person to person. CONCLUSIONThe anatomy and the developmental properties of the sternum should be well understood in cases of potential chest and sternum injuries and in several surgical procedures. Therefore, knowledge of the development and the maturation of the sternum, and sternal variations and anomalies is important. We suggest that the postnatal development and the morphogenesis of the sternum can be adequately assessed using MDCT.T he sternum is a flat bone that extends vertically through the middle of the anterior thoracic cage. The sternum consists of the following three parts: the manubrium, the body, and the xiphoid process (XP) (1, 2). The sternum develops over a long period of time, which begins during the prenatal period and continues through the third and fourth decades of the postnatal period (3-6). Ossification centers in the manubrium and the body form on cartilage plates that are located on both sides of the middle line during the prenatal period. The ossification centers in the manubrium generally merge before birth. Two or more ossification centers that develop on each segment of the mesosternum (body) are referred to as sternebrae, which are located on cartilage plates on both sides of the middle line. From 6-12 years of age, the ossification centers usually merge completely into a single ossification center. The calcification and the fusion of the sternebrae are usually complete by 25 years of age (6-8). Postnatal development, maturation, and ossification center development of the sternum differ significantly from person to person.Several radiographic studies in the literature have evaluated sternal deve...

Morphological approach of the sternal foramen: an anatomic study and a short review of the literature

“…Reported incidence ranges from 0.06% to 18.3%. Prevalence of SF is reported from 0.06% up to 11.6% in radiological studies [4,5,8,18,20,24,26,30], 6.7% to 16.6% in cadaveric studies [3,9,19], and 13.8% and 18.3% in the 2 published anatomic studies, conducted in dry specimens [12,21]. SFs were observed in 5 of 35 sterna (14.6% of dried specimens) in the present study.…”

“…Xiphoidal foramen constitutes the most common type of sternal foramen and, concerning SF in body, it is fundamentally observed in 5 th intercostal segment [8,11,13,21,30]. However, prevalence of SF in body is reported to be higher than this in xiphoid process in specific studies [5,12]. In our study, SFs were, in 60% of the sterna with SF, in xiphoid process, while, in 40%, in the body of the sternum detected.…”

“…Subsequently, sternal bone ossification is accomplished by endochondral ossification, a procedure regulated from specific ossification centres, localised in the manubrium (one ossification point), and, in the mesosternum (three ossification points). Ossification is conducted along specific segments in the mesosternum, known as sternebrae [5]. Sternum is subjected to size and morphologic alterations until 30 th year, while segmental fusion may be extended until 25 th year of the life [10,28].…”

Evaluation of the morphological characteristic and sex differences of sternum by multi-detector computed tomography

“…The sternal bone ossification is accomplished by endochondral ossification, a procedure regulated from specific ossification centers. Ossification is conducted along specific segments in the mesosternum, known as sternebrae [25]. Sternal ossification begins at 5th month of prenatal life.…”

Honeycomb sterna: an unusual case of a developmental abnormality in the sternum

“…Development of the sternum begins during the sixth week of intrauterine life, originating from a pair of longitudinal mesenchymal bands on either side of the anterior chest wall, which then migrate medially to form the cartilaginous sternum [9,14]. Fusion of these two halves-known as the sternal bars-progresses from the cranial end to the caudal end of the sternum in a process which normally completes by the tenth week [2,5,10]. The cartilaginous sternum then ossifies from several ossification centres that appear in craniocaudal sequence around the fifth-to-sixth gestational weeks [14].…”