DOI: N/A
Nirzor MAC, Das SC, Tafadar IH, Sarower MS, Chowdhury T
Background: Mediastinal masses comprise a diverse group of thoracic lesions and remain a diagnostic challenge because of their complex anatomical location. The reported incidence of mediastinal masses has increased over recent decades, and accurate imaging plays a crucial role in evaluation. Multidetector computed tomography (MDCT) is considered the investigation of choice for assessment of mediastinal lesions.
Objective: To evaluate the diagnostic usefulness of MDCT in mediastinal masses and correlate imaging findings with cytopathology, including assessment of sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV).
Methods: This prospective cross-sectional study was conducted in the Department of Radiology and Imaging, Sylhet MAG Osmani Medical College Hospital, from September 2019 to August 2021. Ninety-six patients with suspected mediastinal mass underwent contrast-enhanced CT followed by cytopathological examination. Data were analyzed using SPSS version 25.
Results: The anterior mediastinum was the most common site (45.8%). Malignant lesions accounted for 60.4% and benign lesions for 39.6%. Lymphadenopathy was most frequent (42.7%), followed by thymoma, germ cell tumor, abscess (each 8.3%), esophageal lesions (7.3%), thyroid masses and neurogenic tumors (each 6.3%). For malignant masses, MDCT showed sensitivity 96.5%, specificity 89.5%, and accuracy 93.7%. For benign lesions, sensitivity was 89.5%, specificity 96.5%, and accuracy 93.7%.
Conclusion: MDCT is a highly sensitive, specific, and accurate modality for evaluating mediastinal masses, effectively determining lesion characteristics and reliably differentiating benign from malignant lesions.