Learning objectives
-To review the normal anatomy of the mediastinum and its key anatomical landmarks in acute mediastinitis diagnosis.
-To describe basic radiological findings of acute mediastinitis in plain simple X-ray and in CT Scan.
-To review the most prevalent causes of acute mediastinitis.
Background
Acute mediastinitis is generally described as an inflammation of the soft tissues surrounding the different structures of the mediastinum.
The aim of the following presentation is to give the general radiologist some tips and tricks to diagnose an Acute Mediastinitis in the ER.
Awareness of the clinical manifestations and imaging findings is crucial for making an accurate and timely diagnosis in order to provide the patient´s best treatment.
Although the term “Mediastinitis” reflects a general inflammation of the mediastinal soft tissues,
we can identify,
different...
Findings and procedure details
1.
ANATOMICAL REVIEW
A thorough knowledge of Mediastinal Anatomy and the possible pathways of infection spreading from adjacent sites is basic to understand the pathophysiology of the different types of acute mediastinitis.
Fig. 1
The mediastinum extends from the thoracic inlet superiorly to the diaphragm inferiorly and from the sternum anteriorly to the thoracic vertebrae posteriorly.
1.1.-Felson´s classification of Mediastinal spaces,based on arbitrary landmarks outlined on the lateral chest radiograph Fig. 2 has been widely used.
1.2.- A new scheme based on cross-sectional imaging,
principally...
Conclusion
ER radiologist plays an essential role in Acute Mediastinitis diagnosis.
An early and accurate diagnosis by the ER Radiologist ,
mainly based on CT scan findings ,
is essential for a rapid treatment onset.
Radiological diagnosis must rely on a thorough knowledge of normal mediastinum anatomy,
pathological-radiological findings in acute mediastinitis and a proper understanding of the most prevalent clinical entities.
Personal information
Radiology Department.
Hospital Universitario Infanta Leonor (Vallecas).
Unidad Central de Radiodiagnósticode la CAM.
MADRID.
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