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Prevalence of the Juxtaphrenic Peak After Upper Lobectomy

Eli Konen1, Judith Rozenman1, David A. Simansky2, Alon Yellin2, Inesa Greenberg1, Osnat Konen3, Marjorie Hertz1 and Yacov Itzchak1

1 Department of Diagnostic Imaging, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, 52621 Israel.
2 Department of Thoracic Surgery, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, 52621 Israel.
3 Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Center, Sackler School of Medicine, Tel-Aviv University, Israel.



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  		Fig. 1A. —64-year-old man after right upper lobectomy. Erect posteroanterior chest radiograph obtained 2 years after surgery shows long thin juxtaphrenic peak (arrow) on right.

 


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  		Fig. 2A. —57-year-old woman after left upper lobectomy. Erect posteroanterior chest radiograph shows double-peak (arrow) juxtaphrenic peak on left.

 


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  		Fig. 1B. —64-year-old man after right upper lobectomy. Axial CT scan obtained at level of lung bases shows inferior accessory fissure (arrows) to be cause of radiologic finding of juxtaphrenic peak.

 


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  		Fig. 2B. —57-year-old woman after left upper lobectomy. Axial CT scan obtained at level of lung bases reveals inferior accessory fissure (short arrows). One additional linear structure (long arrows), possibly septum or scar, extends posteriorly toward posterior chest wall.

 


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  		Fig. 2C. —57-year-old woman after left upper lobectomy. Coronal reformation obtained at level of anterior part of inferior accessory fissure (arrow) shows fissure to correspond to lateral peak of juxtaphrenic peak.

 


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  		Fig. 3. —67-year-old man after left upper lobectomy. Axial CT scan obtained at level of lung bases shows oblique orientation of inferior accessory fissure (arrowheads), which explains why no juxtaphrenic peak could be identified on chest radiograph (not shown).

 

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