[Diagnostic imaging of mediastinal tumors. Sensitivity and specificity of sonography in comparison with computed tomography and conventional x-ray diagnosis]

Abstract

The purpose of this prospective study was to evaluate the sensitivity of mediastinal sonography compared to CT and chest radiography in the detection of mediastinal tumors. The sonograms, computed tomograms and chest radiographs of 182 patients were interpreted blindly by three observers and the results of all three procedures were compared. The proportion of diagnostic sonographic examinations varied in the different mediastinal compartments from 85% (subcarinal region) to 96% (supra-aortic region). The sensitivities of sonography and chest radiography (using CT as the gold standard) in the imaging of mediastinal tumors for each compartment were as follows: supra-aortic region: 98% and 67%; paratracheal region: 89% and 69%; aorticopulmonary window: 81% and 62%; prevascular region: 92% and 46%; subcarinal region: 69% and 31%; pericardial region: 100% and 67%; posterior mediastinum: 6% and 6%; paravertebral region: 11% and 44%. These results show that sonography is superior to chest radiography for the diagnosis of mediastinal tumors. In certain mediastinal regions (supra-aortic, pericardial, prevascular and paratracheal region), sonography is so sensitive that CT and MR examinations may be avoided in cases with equivocal radiographic findings.