1. ANATOMY OF MEDIASTINUM Dr Nikrish S Hegde

2. MEDIASTINUM Middle space In the thoracic cavity Between the lungs 3. DIVISIONS Divided into compartments Why? 1) Aid in localization of lesion. 2) Aid in the differential diagnosis. 4. SuperiorInferiorAnterior 2) Middle 3) Posterior 1) 5. SUPERIOR MEDIASTINUM Anteriorly: Manubrium sterniPosteriorly: Upper 4 thoracicvertebrae Superiorly : Plane of thoracic inlet Inferiorly : An imaginary line passing through the sternal angle and lower border of 4th thoracic vertebrae. 6. INFERIOR MEDIASTINUMAnterior Middle Posterior 7. ANTERIOR MEDIASTINUM Thymus, Internal mammary Artery, Lymph Nodes, Fat 8. MIDDLE MEDIASTINUM Heart ,Aorta, Brachiocephali c artery, SVC,IVC, Azygos, Hemiazygos, Phrenic , Vagus Trachea , Lymph nodes 9. POSTERIOR MIDIASTINUM Lymph Nodes, Fat , Vertebral Column & Nerves 10. CT BRIEF OVERVIEW Localization Extent Characterise Shortening of scanning time Limit the total dose of contrastCT is usually used to further evaluate an abnormality detected on Chest radiograph. 11. NON CONTRAST - CT Scan time is less.No contrast reaction. Cost is lower.Takes longer time to interpret. 12. CONTRAST ENHANCED CT 2 ml 4ml/secTotal 150 ml Large bore iv catheter18-20 gauge Time of the bolus in relation to the scan varies. 13. CT scans of the mediastinum arereconstructed, filmed and interpreted in an axial format. Continuous data can be acquired in a single breath hold and therefore excellent 2D and 3D reconstruction of images is done. 14. AXIAL PLANE. 15. THORACIC INLET 16. LEFT BRACHIOCEPHALIC VEIN 17. AORTIC ARCH 18. AZYGOS VEIN 19. AORTO-PULMONARY WINDOW 20. LEFT PULMONARY ARTERY 21. RIGHT PULMONARY ARTERY 22. LEFT ATRIAL 23. 4 CHAMBER 24. 3 CHAMBER 25. CORONAL PLANE. 26. AORTIC OUTFLOW TRACT 27. PULMONARY ARTERY 28. LEFT ATRIAL 29. DESCENDING AORTA 30. SAGITTAL PLANE. 31. SVC 32. RIGHT ATRIAL LEVEL 33. AORTIC OUTFLOW TRACT 34. PULMONARY OUTFLOW TRACT 35. LYMPH NODES 36. SUPRACLAVICULAR & UPPER PARATRACHEAL 37. PREVERTEBRAL & PREVASCULAR 38. LOWER PARATRACHEAL 39. SUBAORTIC & PARA AORTIC 40. CARINAL, PARAOESOPHAGEAL & HILAR