Multi Slice Computed Tomography in Assessment of Posterior Mediastinal Lesions

Abstract

Background: Posterior Mediastinal lesions are relatively common and represent 23-30% of all mediastinal lesions; 40% of these lesions are an incidental finding. Multidetector CT (MDCT) has shorter imaging time and better spatial resolution than MRI, especially in mediastinum; it is more widely available & less expensive. The additional role of CT is in performing CT guided biopsies if needed. This study aimed to evaluate the role of MSCT in the diagnosis of mediastinal lesions based on the characteristic imaging appearances, which can lead to a correct diagnosis and optimal management. The post-processing technique further improves the diagnosis and surgical planning.
 Patients and Methods: This study included 30 patients with posterior mediastinal lesions evaluated according to clinical data, diagnostic imaging procedure (MSCT), and histopathological evaluation. Most of the cases in this study had a lesion raised from the LN and vessels by 23.3%.
 Results: Metastatic lymphadenopathy was the commonest lesion in our study, 13.3%, followed by lymphoma 10.3% and neurogenic tumors 10%. Benign lesions were 60%, while the malignant lesion represents 40% of all cases. Multiple CT features of each posterior mediastinal lesion were used to predict the nearest histological diagnosis. The accuracy of MSCT in our study was 93.3%.
 Conclusion: MSCT has a practical and significant role in the assessment & evaluation of the posterior mediastinal lesions according to the anatomical origin, the CT feature of the lesion (solid or cystic), density, the effect on the surroundings, the distribution pattern, and extent of the lesion.