Effect of contrast medium on early detection and analysis of mediastinal lymph nodes in computed tomography

Rev Assoc Med Bras (1992). 2023 Feb 20;69(3):392-397. doi: 10.1590/1806-9282.20220869. eCollection 2023.

Abstract

Objective: This study aimed to evaluate the diagnostic efficiency of contrast-to-noise and signal-to-noise ratios created by the contrast medium in detecting lymph nodes.

Methods: In this study, 57 short-axis subcentimeter lymph nodes in 40 cardiac computed tomography patients with noncontrast- and contrast-enhanced phases were evaluated. The contrast-to-noise ratios and signal-to-noise ratios of noncontrast- and contrast-enhanced lymph node-mediastinal fat and aortic-mediastinal fat tissues were determined. In addition, lymph nodes in noncontrast- and contrast-enhanced series were evaluated subjectively.

Results: There was a significant difference in lymph node-mediastinal fat signal-to-noise values between the contrast and noncontrast phases (p=0.0002). In the contrast phase, aortic density values were found to be 322.04±18.51 HU, lymph node density values were 76.41±23.41 HU, and mediastinal adipose tissue density values were -65.73±22.96 HU. Aortic-mediastinal fat contrast-to-noise ratio value was 20.23±6.92 and the lymph node-mediastinal fat contrast-to-noise ratio value was 6.43±2.07. A significant and moderate correlation was observed between aortic-mediastinal fat and lymph node-mediastinal fat contrast-to-noise ratio values in the contrast phase (r=0.605; p<0.001). In the contrast-enhanced series, there was a significant increase in the subjective detection of lymph nodes (p=0.0001).

Conclusion: In the detection of paratracheal lymph nodes, the contrast agent increases the detection of short-axis subcentimeter lymph nodes quantitatively and qualitatively. Contrast enhances and facilitates the detection of paratracheal lymph nodes.

MeSH terms

  • Humans
  • Lung Neoplasms* / pathology
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Mediastinum* / diagnostic imaging
  • Tomography, X-Ray Computed / methods