Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography

AKIN K., Kosehan D., Topcu A., Koktener A.

Skeletal Radiology, vol.40, no.4, pp.447-452, 2011 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 4
  • Publication Date: 2011
  • Doi Number: 10.1007/s00256-010-1022-1
  • Journal Name: Skeletal Radiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.447-452
  • Keywords: Xiphoid bone, Tomography, Spiral computed, Individual differences, STERNUM, APPEARANCES
  • Lokman Hekim University Affiliated: No


Objective: The aim of this study was to evaluate the interindividual variations of the xiphoid process in a wide adult group using 64-row multidetector computed tomography (MDCT). Materials and methods: Included in the study were 500 consecutive patients who underwent coronary computed tomography angiography. Multiplanar reconstruction (MPR), maximum intensity projection (MIP) images on coronal and sagittal planes, and three-dimensional volume rendering (VR) reconstruction images were obtained and used for the evaluation of the anatomic features of the xiphoid process. Results: The xiphoid process was present in all patients. The xiphoid process was deviated ventrally in 327 patients (65.4%). In 11 of these 327 patients (2.2%), ventral curving at the end of the xiphoid process resembled a hook. The xiphoid process was aligned in the same axis as the sternal corpus in 166 patients (33.2%). The tip of the xiphoid process was curved dorsally like a hook in three patients (0.6%). In four patients (0.8%), the xiphoid process exhibited a reverse S shape. Xiphoidal endings were single in 313 (62.6%) patients, double in 164 (32.8%), or triple in 23 (4.6%). Ossification of the cartilaginous xiphoid process was fully completed in 254 patients (50.8 %). In total, 171 patients (34.2%) had only one xiphoidal foramen and 45 patients (9%) had two or more foramina. Sternoxiphoidal fusion was present in 214 of the patients (42.8%). Conclusions: Significant interindividual variations were detected in the xiphoid process. Excellent anatomic evaluation capacity of MDCT facilitates the detection of variations of the xiphoid process as well as the whole ribcage. © 2010 ISS.