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Mediastinum (ITMIG classification)

Dr Francis Deng and Dr Henry Knipe ◉ ◈ et al.

The International Thymic Malignancy Interest Group (ITMIG) classification of mediastinal compartments was developed to reflect a division of the mediastinum based on cross-sectional imaging. It was in part an effort to consolidate prior discrepant classification systems in use by different medical specialties. A working group composed of approximately 225 experts in thoracic surgery, medical oncology, diagnostic radiology, and pathology were tasked with forming a practical system for anatomic classification which unified the various systems.

Classification

The ITMIG classification divides the mediastinum into three compartments: prevascular, visceral and paravertebral ^1,2.

Prevascular compartment

Boundaries

superior: thoracic inlet
inferior: diaphragm
anterior: posterior cortex of the sternum
lateral: parietal mediastinal pleura
posterior: anterior aspect of the pericardium

Contents

Visceral compartment

Boundaries

superior: thoracic inlet
inferior: diaphragm
anterior: posterior boundary of the prevascular compartment
posterior: a vertical line connecting a point on each thoracic vertebral body 1 cm posterior to its anterior margin (visceral-paravertebral compartment boundary line)

Contents

trachea/carina
esophagus
lymph nodes
heart
ascending aorta; aortic arch; descending thoracic aorta
superior vena cava
intrapericardial pulmonary arteries
thoracic duct

Paravertebral compartment

Boundaries

superior: thoracic inlet
inferior: diaphragm
anterior: posterior boundaries of the visceral compartment
posterolateral: vertical line against the posterior margin of the chest wall at the lateral margin of the thoracic spine

Contents

thoracic spine and paravertebral soft tissues

References

Anatomy: Thoracic

thoracic skeleton
- thoracic cage
  - ribs
    - typical ribs
    - atypical ribs
    - variant anatomy
      - bifid ribs
      - Srb anomaly
  - costal cartilage
  - sternum
- thoracic spine
- articulations
muscles of the thorax
spaces of the thorax
thoracic viscera
blood supply of the thorax
- arteries
  - thoracic aorta (development)
  - pulmonary trunk
    - left pulmonary artery
      - aberrant left pulmonary artery
    - right pulmonary artery
- veins
  - superior vena cava (cavoatrial junction)
  - inferior vena cava
  - coronary veins
    - cardiac veins which drain into the coronary sinus
      - great cardiac vein
      - middle cardiac vein
      - small cardiac vein
      - posterior vein of the left ventricle
      - vein of Marshall (oblique vein of the left atrium)
    - anterior cardiac veins
    - venae cordis minimae (smallest cardiac veins or thebesian veins)
  - pulmonary veins
    - bronchial veins
lymphatics
innervation of the thorax

Article information

rID: 52066

System: Vascular, Chest, Cardiac

Section: Anatomy, Classifications

Tag: refs, cases, cases

Synonyms or Alternate Spellings:

International Thymic Malignancy Interest Group (ITMIG) classification of mediastinal compartments
ITMIG classification of mediastinal compartments

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