Learning objectives
Illustrate and review the anatomy of the mediastinum.
Create an easy step by step guide in approaching mediastinal lesions.
Find a systematic approach to the differential diagnosis of mediastinal lesions, with emphasis on computer tomography (CT).
Background
The mediastinum is a complex anatomical region which contains vital structures.
Its name comes from the lat.: “media” and “stare”, meaning “standing in the middle”.
A variety of both benign and malignant mediastinal masses can be encountered and often represent a diagnostic challenge.
The anatomical localization and imaging features of different lesions guide the radiologist towards the correct diagnosis.
Findings and procedure details
ANATOMY
The mediastinum is defined as the space between the lungs containing vital anatomical structures: the heart, pericardium,great vessels, trachea, main bronchi, thymus, lymph nodes and esophagus.
Several classification systems are used in daily practice to divide the mediastinuminto compartments, which help narrow down the differential diagnosis:
Gray's Anatomy:
The most classic anatomical representation of mediastinal compartments can be found in Gray’s anatomy, which divides the mediastinum into a superior, middle, anterior and posterior section (Fig.1, Fig.2).1,2
Felsons classification:
Describesmediastinal divisions on lateral chest x-ray...
Conclusion
Knowledge of the anatomical position and imaging characteristics of different mediastinal masses are very helpful in reaching an accurate diagnosis. CTis the most frequently used imaging modality.
Personal information and conflict of interest
S. Abu Arif; Herning/DK - Author at Regional Hospital West Jutland, Herning V. Helbo Jensen; Herning/DK - Author at Regional Hospital West Jutland, Herning
References
Carter BW et al. A modern definition of mediastinal compartments. J Thorac Oncol.2014 Sep;9(9 Suppl 2):97-101
Liu W, Deslauriers J. Mediastinal divisions and compartments. Thorac Surg Clin.2011 May;21(2):183-90.
Felson, B.Chest Roentgenology.WB Saunders,Philadelphia PA;1973.
Carter BW et al. ITMIG Classification of Mediastinal Compartments and Multidisciplinary Approach to Mediastinal Masses; Radiographics. 2017 Mar-Apr;37(2):413-436.
Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L. A diagnostic approach to the mediastinal masses.Insights Imaging. 2013;4(1):29–52.
Aroor AR,Prakasha S R,Seshadri S,S T,Raghuraj U. A study of clinical characteristics of...