Imaging the posterior mediastinum: a multimodality approach

Occhipinti, Mariaelena; Heidinger, Benedikt H.; Franquet, Elisa; Eisenberg, Ronald L.; Bankier, Alexander A.

doi:10.5152/dir.2014.14467

Cited by 30 publications

(26 citation statements)

References 75 publications

(142 reference statements)

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“…Classification of posterior mediastinal masses- [4,5] Right aortic arch can be associated with aberrant left subclavian artery. Left subclavian artery arises from descending aorta from diverticulum.…”

Section: Diagnosis:-mentioning

confidence: 99%

“…On CT, they appear as well defined soft tissue masses in paravertebral region and may show heterogenous appearance due to hemorrhage, necrosis, cystic degeneration or calcification. [4,5] Neurofibromas are usually more homogenous in appearance than Schwannomas. They may cause enlargement of neural foramina or pressure erosion of adjacent rib/scalloping of posterior vertebral bodies.…”

Section: Diagnosis:-mentioning

confidence: 99%

“…On MRI, neurofibromas show "target"appearance on T2W with low signal intensity in center and high signal intensity rim. [5] Presence of multiple target signs throughout the lesion on MRI favors the diagnosis of plexiform neurofibroma.…”

Section: Diagnosis:-mentioning

confidence: 99%

See 2 more Smart Citations

Spectrum of Ct Findings in Posterior Mediastinal Masses

Vohra¹,

Narula²,

Bindra³

2016

IJAR

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Section: Diagnosis:-mentioning

confidence: 99%

Section: Diagnosis:-mentioning

confidence: 99%

See 1 more Smart Citation

Spectrum of Ct Findings in Posterior Mediastinal Masses

Vohra¹,

Narula²,

Bindra³

2016

IJAR

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show abstract

“…Currently, MRI is the gold standard used to diagnosis patients with thoracic extramedullary hemopoiesis (9). When thoracic extramedullary hemopoiesis presents as posterior mediastinum masses in specific clinical contexts, it is easy to diagnose by MRI (10). The other radiological presentations, such as those observed in intrathoracic mass, may be more difficult to diagnose by MRI and CT as they are not associated with adjacent bone destruction and require biopsy (11).…”

Section: Introductionmentioning

confidence: 99%

A comparison of computed tomography with magnetic resonance imaging for the diagnosis of thoracic extramedullary hemopoiesis in patients with leukemia: A non‑inferiority retrospective diagnostic study

Ling¹,

Xia²,

Wang

2020

Oncol Lett

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At present, MRI is the primary choice of examination for the diagnosis of thoracic extramedullary hemopoiesis. When thoracic extramedullary hemopoiesis presents as posterior mediastinum masses in specific clinical contexts, the diagnosis is not challenging. Other radiological presentations may be more difficult for diagnosis and require biopsy. Needle biopsy is typically preferred for the diagnosis of extramedullary hemopoiesis however, the high vascularization of tissues is one of the complications of this method thus, it is avoided. The aim of the present study was to compare the diagnostic parameters of CT with MRI for the diagnosis of thoracic extramedullary hemopoiesis in patients with leukemia, with an open lung biopsy as a reference standard. Chest CT, chest MRI and open lung biopsy data from a total of 912 patients with leukemia with a sign(s) and symptoms of suspected paravertebral and/or pulmonary extramedullary hemopoiesis were reviewed. In the present study, thoracic extramedullary hemopoiesis was defined as diffusivity of both lung fields being increased compared with the blood pool and no other abnormal focal of lungs being increased compared with the blood pool. The beneficial score was calculated for CT and MRI and plotted for the decision making of irradiation. With respect to open lung biopsy, MRI had a higher sensitivity compared with CT (0.865 vs. 0.809; P<0.0001; q=1691) however, CT had a higher accuracy compared with MRI (0.833 vs. 0.733; P<0.0001; q=3020). The low rate of overdiagnosis was observed for both methods for the detection of thoracic extramedullary hemopoiesis however, the working area for detecting thoracic extramedullary hemopoiesis at least once in images was higher for MRI compared with CT. CT and MRI both have diagnostic importance in the detection of thoracic extramedullary hemopoiesis in patients with leukemia however, chest MRI misdiagnoses the condition while CT can confirm it (level of evidence, 3).

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“…For patients with contraindications for contrast-enhanced CT (such as renal failure or contrast allergy), non-contrast MRI may be performed to characterize mediastinal tumors and evaluate involvement of vascular structures [23][24][25][26]. More importantly, cardiac-gated MRI, which is the gold standard for evaluating the pericardium [27] and heart, can provide dynamic imaging and assess the sliding motion of the tumor throughout the cardiac cycle.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Utility of Cardiac-Gated Magnetic Resonance Imaging for Assessing Surgical Resectability of Mediastinal Tumors

Ong

Seet

Tam

et al. 2017

Cardiovasc Imaging Asia

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Objective: To evaluate the diagnostic utility of cardiac-gated magnetic resonance imaging (MRI) for assessing surgical resectability of mediastinal tumours. Materials and Methods:We searched our database for cardiac-gated MRI scans [cine steady-state free precession (SSFP), T1-weighted spin-echo sequences] performed for mediastinal tumor staging. Nine patients underwent both cardiac-gated MRI and non-cardiac-gated computed tomography (CT) scans with subsequent surgical confirmation. Pathological diagnoses were germ cell tumors (n=4) and thymic tumors (n=5). The criteria for mediastinal invasion on CT included tumor abutment of mediastinal structures (>90 degrees) with loss of the intervening fat plane or direct vascular invasion, while those for MRI included absence of sliding motion between tumor and mediastinal structure or direct vascular invasion. Imaging findings were compared and correlated to surgical/histopathological findings.Results: CT showed 48 mediastinal structures with tumor abutment (>90 degrees), with 19 structures confirmed to be involved intraoperatively. MRI showed 38 structures with tumor abutment (>90 degrees), with 18 structures confirmed to be involved intraoperatively. The accuracy, sensitivity, and specificity in determining mediastinal invasion using the presence of tumor abutment of mediastinal structures (>90 degrees) on CT were 50.8 (31/61), 95 (19/20), and 29.3% (12/41), respectively, and those for MRI were 63.9 (39/61), 90 (18/20), and 51.2% (21/41). Cardiac-gated cine SSFP images showed loss of sliding motion in 15 structures, with 14 confirmed to be involved intraoperatively. The accuracy, sensitivity, and specificity in determining mediastinal invasion using absence of sliding motion were 88.5 (54/61), 70 (14/20), and 97.6% (40/41), respectively. Conclusion:This study shows that cardiac-gated MRI is more accurate than non-cardiac-gated CT in mediastinal tumor staging. However, because of higher cost, cardiac-gated MRI may be used to detect mediastinal invasion when findings are equivocal on CT.

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Imaging the posterior mediastinum: a multimodality approach

Cited by 30 publications

References 75 publications

Spectrum of Ct Findings in Posterior Mediastinal Masses

Spectrum of Ct Findings in Posterior Mediastinal Masses

A comparison of computed tomography with magnetic resonance imaging for the diagnosis of thoracic extramedullary hemopoiesis in patients with leukemia: A non‑inferiority retrospective diagnostic study

The Diagnostic Utility of Cardiac-Gated Magnetic Resonance Imaging for Assessing Surgical Resectability of Mediastinal Tumors

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