IMAGING PHENOTYPES OF PEDIATRIC MEDIASTINAL MASSES ON MULTIDETECTOR COMPUTED TOMOGRAPHY AND THEIR ASSOCIATION WITH UNDERLYING ETIOLOGY.”
Abstract
Background: Pediatric mediastinal masses represent a diagnostically challenging entity due to their diverse etiologies and potential compromise of vital thoracic structures. Computed tomography (CT) is pivotal for anatomical characterization; however, its diagnostic accuracy in the pediatric population requires validation against histopathological reference standards.
Objective: To determine the diagnostic accuracy of multidetector computed tomography (MDCT) in evaluating mediastinal masses in pediatric patients using histopathology as the gold standard, and to describe the spectrum of mediastinal pathologies encountered.
Methods: This descriptive cross-sectional study was conducted at the Radiology Department of Ali Medical Centre, Islamabad, Pakistan, over four months. A total of 30 pediatric patients (aged 1–7 years) with clinically or radiographically suspected mediastinal masses were enrolled through non-probability consecutive sampling. All participants underwent contrast-enhanced MDCT (Toshiba Aquilion 64-slice). CT findings were compared with histopathological results. Sensitivity and specificity were calculated for individual mass categories.
Results: The mean age was 5.2 ± 1.8 years, with a male predominance (n=16, 53.3%). Anterior mediastinal masses were more common (70%) than posterior (30%). Thymus masses were the most frequent pathology (43.3%), followed by lipoma (30%), lymphadenopathy (26.7%), and sarcoma (10%). CT demonstrated 100% sensitivity for sarcoma, anterior mediastinal mass, and posterior mediastinal mass; 89% for lipoma; and 76% for thymus mass. Specificity was 100% for thymus mass and posterior mediastinal mass, 89% for anterior mediastinal mass, 74% for sarcoma, 68% for lymphadenopathy, and 38% for lipoma.
Conclusion: MDCT demonstrates high diagnostic accuracy for mediastinal masses in pediatric patients, with excellent sensitivity and variable specificity across lesion subtypes. It remains an indispensable tool for characterization, compartmental localization, and treatment planning in pediatric mediastinal pathology.
Keywords
- Computed Tomography, Mediastinal Mass, Pediatric, Diagnostic Accuracy, Lymphadenopathy, Thymus
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