Role of Multidetector Computed Tomography in the Evaluation of Mediastinal Mass Lesions
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2018, Vol 7, Issue 4
Abstract
Introduction: The mediastinum consists of important vascular and nonvascular tissues and organs. Partition of the mediastinum into specific compartments aids in differential diagnosis of the masses, assistance in biopsies, and other surgical procedures. Objective: To evaluate the role of multidetector Computed Tomography (MDCT) in the assessment of mediastinal mass lesions based on International Thymic Malignancy Interest Group (ITMIG) classification. Materials and Methods: A one year cross-sectional study was conducted on 45 patients with clinical diagnosis of mediastinal mass lesion in the Department of Radiology. On admission, patients were interviewed regarding the demographic data and underwent clinical examination before the CT examination. The compartment localisation was done based on the ITMIG classification system. All the cases were evaluated for compartment localisation and MDCT features of the mediastinal mass along with the involvement of the adjoining structures. The preand post-contrast attenuation values, the size, location of the mass, presence of calcification, mass effect on adjoining structures, and infiltration were recorded. The CT-guided biopsy of the mass lesions was performed to conduct histopathological analysis. Data were recorded in a predesigned and pretested proforma. The data were coded and entered in Microsoft excel worksheet. Results: The majority (32) of the patients in the present study were men with most of them in the age group of 61- 70 years, and the mean age was 44.77±21.29 years. The compartment localisation of the mediastinal mass lesions revealed majority of the lesions (21) in the pre-vascular compartment. Upon CT enhancement, heterogenous lesions were observed in many patients (29). CT-guided biopsy (30) was the most frequently performed method. Histopathological analysis revealed thymoma (9) in most of the cases. Malignancy (23) was observed in many of the patients with mediastinal lesions. Lymphoma was the common CT diagnosis in patients with solid component (10), lymphadenopathy (8), and infiltration (7). Conclusion: MDCT is a useful modality in evaluating the mediastinal lesions, and provides precise information regarding the extent, tissue composition, lesion enhancement pattern, and mediastinal and vascular invasion.
Authors and Affiliations
V V Hattiholi, Pallav Gupta, Jyothi Hattiholi
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