Tecce P M, Fishman E K, Kuhlman J E
Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins Medical Institutions, Baltimore, Md 21205.
Radiographics. 1994 Sep;14(5):973-90. doi: 10.1148/radiographics.14.5.7991827.
Computed tomography (CT) is the study of choice for evaluating disease in the anterior mediastinum. Mediastinal CT is usually performed with intravenously administered contrast material, and spiral CT is the preferred technique for evaluating a mediastinal mass. CT demonstrates thymic hyperplasia and thymic cysts and can help differentiate thymoma and thymic Hodgkin lymphoma. It is also useful in staging Hodgkin lymphoma and non-Hodgkin lymphoma. In thyroid malignancy, CT can depict mediastinal extension and lymphadenopathy; it also allows detection of goiter and ectopic parathyroid glands. Germ cell tumors such as teratoma and seminoma have characteristic appearances at CT. CT can also demonstrate miscellaneous mediastinal masses, such as lymphangioma, hematoma, those due to fibrosing mediastinitis, and pericardial cysts. Adenopathy due to tuberculosis or sarcoidosis is evident at CT, as is osteomyelitis due to a postsurgical abscess. Finally, CT features can suggest the pathologic origin of metastasis in the anterior mediastinum.
计算机断层扫描（CT）是评估前纵隔疾病的首选检查方法。纵隔CT通常在静脉注射造影剂的情况下进行，螺旋CT是评估纵隔肿块的首选技术。CT可显示胸腺增生和胸腺囊肿，并有助于鉴别胸腺瘤和胸腺霍奇金淋巴瘤。它在霍奇金淋巴瘤和非霍奇金淋巴瘤分期中也很有用。对于甲状腺恶性肿瘤，CT可显示纵隔侵犯和淋巴结病；它还能检测甲状腺肿和异位甲状旁腺。诸如畸胎瘤和精原细胞瘤等生殖细胞肿瘤在CT上有特征性表现。CT还可显示各种纵隔肿块，如淋巴管瘤、血肿、纤维性纵隔炎所致肿块以及心包囊肿。由结核或结节病引起的淋巴结病在CT上很明显，术后脓肿所致骨髓炎在CT上也很明显。最后，CT特征可提示前纵隔转移瘤的病理来源。
