Chest and Mediastinal Imaging

The mediastinum is a complex anatomic space within the central thoracic cavity, surrounded by the lungs. It extends from the thoracic inlet superiorly to the diaphragm inferiorly. The mediastinum contains multiple vital organs and anatomical structures. Understanding anatomy helps narrow the differential while evaluating mediastinal masses, which helps recommend the right imaging modality. Mediastinal pathology ranges from congenital abnormalities and vascular, traumatic, and infective etiologies to benign and malignant neoplasms. While computed tomography (CT) is considered the imaging modality of choice, magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT), and ultrasonography are also helpful in narrowing the differential. Chest radiography is the most common initial imaging modality for evaluating the mediastinum.