[The diagnostic value of computerized tomography in mediastinal diseases depending on their localization].

Abstract

The diagnostic ranking and importance of computerised tomography was examined in 116 patients with abnormal findings in the mediastinal region, and was compared with conventional, non-invasive x-ray examinations. This method also yielded significant CT-specific additional information in the anterior mediastinum in 74.4% of the cases, in the mesomediastinum in 69.1%, in the posterior mediastinum in 79.2% in the upper thoracic aperture in 94.4% and in the paracardial region in 100% of the cases. The hilar region is an exception; in 68.8% of the cases, both methods were rated equal, whereas in 28.1% of the cases assessment via the CT method was even inferior. The specific additional information furnished by the CT method justifies a wider application of CT in solving the following problems concerning the mediastinum. -- clarification of a suspected but not yet established space-occupying growth in the mediastinum, before using invasive diagnostic methods such as mediastinoscopy and angiography; -- staging of an already identified primary mediastinal tumor of malignant lymphoma; -- in case of suspected changes in the large mediastinal vessels before employing angiography; -- on-target in the following diseases: bronchogenic carcinoma (because of improved pretherapeutic staging according to the TNM system), myasthenia gravis and identification of thymoma, hyperparathyroidism with suspected dystopic parathyroid glands.