[Indications of valvular pulmonary stenosis on plain chest films (author's transl)].

Plain chest films of 87 children aged 4-14 years with valvular pulmonary stenosis proved by cardiac catheterization and of an age matched control group of 92 healthy children were evaluated in a retrospective study. Up to 4 years the evaluation was impaired by the overlying thymus. The evidence of poststenotic dilatation of the pulmonary trunk and the left pulmonary artery branch together with a normal or increased left sided perihilar pulmonary vascularity is essential for the diagnosis of valvular pulmonary stenosis. The pulmonary trunk showed marked dilatation in 47 cases, mild dilatation in 11 cases and no dilatation in 21 cases. A cranial displacement of the pulmonary trunk which partially reached or overlapped the aortic knuckle was seen in 44 children. 50 children showed a hilar enlargement due to the poststenotic dilatation of the left pulmonary artery branch. 1/5 of the children showed extension of the poststenotic enlargement into the left sided segmental artery branches. Cardiac size, calculated by heart volume, was within age specific limits. No correlation was found concerning the severity of the stenosis and the radiographic findings. Indications of valvular pulmonary stenosis increased with the age of the child.