Hypervascular mediastinal masses: action points for radiologists

Eur J Radiol. 2015 Mar;84(3):489-498. doi: 10.1016/j.ejrad.2014.11.039. Epub 2014 Dec 15.

Abstract

Hypervascular mediastinal masses are a distinct group of rare diseases that include a subset of benign and malignant entities. Characteristic features and known association with syndromes and genetic mutations assist in achieving a diagnosis. Imaging allows an understanding of the vascularity of the lesion and should alert the radiologist and clinician to potential hemorrhagic complications and avoid percutaneous CT guided biopsies. In such cases, pre-procedure embolization and surgical biopsy maybe considered for better control of post procedure hemorrhage. The purpose of this article is to describe and illustrate the clinical features and radiologic spectrum of hypervascular mediastinal masses, and discuss the associated clinical and genetic syndromes. We will present an imaging algorithm to determine further evaluation and subsequently guide treatment.

Keywords: CT; Functional imaging; Hypervascular mediastinal masses; MR.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Biopsy, Needle
  • Embolization, Therapeutic
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging*
  • Mediastinal Neoplasms / diagnostic imaging*
  • Mediastinal Neoplasms / pathology
  • Neoplasms, Fibrous Tissue / diagnostic imaging*
  • Neoplasms, Fibrous Tissue / pathology
  • Predictive Value of Tests
  • Radiography, Interventional*
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*