CT IN MEDIASTINUM.ppt

1. CT IN MEDIASTINUM
DR. VENUGOPAL M.
ASST.PROFESSOR OF IMAGEOLOGY
REGIONAL CANCER CENTRE, THIRUVANANTHAPURAM

2. Normal pa view

3. • CENTRAL DENSE SHADOW IN PA
FILM COMPRISED OF-
• MEDIASTINUM
• HEART
• SPINE
• STERNUM

4. COMPARTMENTS
• DIVISION IS BASED ON CHEST
RADIOGRAPH
• FACILITATES LESION LOCALISATION
• AIDS IN DIAGNOSIS

5. • SUPERIOR
• ANTERIOR
• MIDDLE
• POSTERIOR

6. SUPERIOR
• BETWEEN THORACIC INLET AND
SUPERIOR ASPECT OF AORTIC ARCH
• ALL MEDIASTINAL STRUCTURES
ABOVE AN IMAGINARY LINE DRAWN
BETWEEN STERNAL ANGLE AND 4TH
INTERVERTEBRAL DISC

8. ANTERIOR MEDIASTUNUM
• THE SPACE ANTERIOR TO HEART
AND GREAT VESSELS
• ANTERIORLY STERNUM
• POSTERIORLY PERICARDIUM(antr
border of pericardium)
• CONTENTS-THYMUS, BRANCH OF
INTERNAL MAMMARY ARTERY,LNs,
FAT

9. SUTTONS DIVISION

10. ACCORDING TO FELSON
• ANTR MEDIASTINUM IS BETWEEN
STERNUM ANTRLY AND
• A LINE DRAWN THRU THE ANTR
BORDER OF TRACHEAANDPOSTR
BORDER OF HEART AND IVC
• THUS HEART IS INCLUDED IN THE
ANTR MEDIASTINUM HERE

11. FELSONS DIVISION

12. M IDDLE MEDIASTINUM
• ANTERIORLYANTERIOR BORDER OF
PERICARDIUM
• POSTERIORLY LINE DRAWN 1 cm
POSTERIOR TO THE ANTERIOR
BORDER OF VERTEBRAL BODIES
• STRUCTURES SEEN WITHIN ARE-

13. • HEART
• AORTA
• SVC
• IVC
• BRACHIOCEPHALIC ARTERIES AND VEINS
• PULMONARY ARTERIES AND VEINS
• THORACIC DUCT
• AZYGOUS AND HEMIAZYGOUS VEINS
• PHRENIC NERVE
• VAGUS NERVE
• TRACHEA
• PROX BRONCHI
• MEDIASTINAL FAT
• LNs

14. POSTERIOR MEDIASTINUM
• ANTRLY A LINE DRAWN 1 cm POSTR
TO ANTR BORDER OF VERTEBRAL
BODIES
• POSTERIORLY PARAVERTEBRAL
GUTTERS

15. CONTENTS OF POSTR
MEDIASTINUM
• VERTEBRAL COLUMN
• NERVES
• FAT
• LYMPH NODES

39. ANTERIOR MEDIASTINAL
MASSES

41. THYMIC CYST

42. CYSTIC THYMOMA

44. CECT
a minimally enhancing anterior
mediastinal mass
INVASIVE THYMOMA

46. CECT SCAN SHOWS A HETEROGENEOUS ANTERIOR
MEDIASTINAL MASS WITH AREAS OF FAT , CALCIFICATION ,
FLUID ATTENUATION, AND THIN SOFT-TISSUE SEPTA.

47. LARGE, WELL-DEFINED MEDIASTINAL MASS

48. PHOTOGRAPH OF THE SURGICAL SPECIMEN
SHOWS AN OVAL MASS WITH SEBACEOUS MATERIAL
CARTILAGE, AND NERVE TISSUE

49. SHOWS AN ILL-DEFINED ANTERIOR MEDIASTINAL MASS
WITH IRREGULAR BORDERS & INFILTRATING THE MEDIASTINAL FAT
CT-GUIDED NEEDLE BIOPSY REVEALED A MEDIASTINAL SEMINOMA.

50. RECURRENT CHORIOCARCINOMA RT & CT 4 YEARS EARLIER.
CECT & T2-WI:-
A LOBULATED MASS WITH MIXED SOLID AND CYSTIC
COMPONENTS IN THE ANTERIOR MEDIASTINUM.

51. NECT SCAN THROUGH THE MEDIASTINUM SHOWS
MULTIPLE ENLARGED LYMPH NODES WITH
SMALL, BILATERAL PLEURAL EFFUSION.

52. MIDDLE MEDIASTINAL
LESIONS

55. CECT SCAN SHOWS A THIN-WALLED WATER-ATTENUATION CYST

63. POSTERIOR MEDIASTINAL
LESIONS

65. CT SCAN SHOWS A THIN-WALLED WATER-ATTENUATION CYST
IN THE POSTERIOR MEDIASTINUM

66. CECT scan shows bilateral pleural effusion &
thin-walled periaortic cystic lesion that displaces
the esophagus anteriorly.

67. CHEST CT : LARGE POSTERIOR/MIDDLE MEDIASTINAL MASS
WITH INVASION OF THE SUBCARINAL SPACE.
PERIPHERAL CALCIFICATION IN THE MASS.

68. CT SCAN SHOWS A LOW-ATTENUATION MASS
PROTRUDING FROM THE ENLARGED LEFT
INTERVERTEBRAL FORAMEN.

69. ON A MYELOGRAM,
CONTRAST MEDIUM IS SEEN TO
PASS INTO THE MENINGOCELE

70. CT : a well circumscribed right sided
posterior mediastinal mass
of mixed fat/soft tissue density.
CT upper abdomen show
absence of the spleen,
without evidence of previous
surgical splenectomy

71. THANK YOU