3D Visual Guide to Lines and Stripes in Chest Radiography

Chest radiography continues to be the first-line imaging modality for evaluation of the chest. Interpretation is based on the understanding of complex three-dimensional (3D) structur-al relationships, which are translated into a two-dimensional (2D) plane. These 2D pro-jections form multiple lines and stripes on chest radiographs, representing the interfaces between the pulmonary parenchyma, pleura, and normal mediastinal structures. Given the subtlety of overlying tissue and the need to mentally synthesize planar images into three dimensions, structural relationships may be difficult to appreciate. An understanding of these relationships forms the basis of recog-nizing pathologic conditions and providing an accurate differential diagnosis, which can assist in targeted appropriate further workup. On a 2D radiograph, this means recognizing the normal lines and stripes as well as their ap-pearance when effaced or displaced. Once this abnormality is identified, a focused differen-tial diagnosis can be generated, which can be further narrowed on the basis of other factors, such as patient history or ancillary findings. Three-dimensional cinematic rendering is an innovative tool that can help radiologists grasp these anatomic relationships and discern subtle findings at radiography. This technique allows improved visualization of structures such as the pleura that are difficult to appre-ciate with traditional imaging modalities. The authors provide an updated review of lines and stripes on chest radiographs, using 3D cine-matic rendering as a teaching tool.

Automated summary

Chest radiography is the preferred imaging modality for evaluating the chest. Recognizing lines and stripes on chest radiographs is crucial for identifying pathological conditions. Three-dimensional cinematic rendering can improve visualization of chest structures.