Correlation between chest radiographic findings and chest computed tomography findings in patients presenting with mediastinal masses at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Abstract Background: The mediastinum is a common site for both non-neoplastic and neoplastic lesions, often presenting as mediastinal masses. Accurate diagnosis requires a thorough evaluation of imaging features and distribution. Comparing chest X-ray findings with chest CT scans is crucial in this process. Manifestations on chest radiographs include soft tissue masses, mediastinal widening, or pneumomediatinum. CT imaging provides a detailed assessment of texture (cystic versus solid) and content (calcium or fat), enhancement pattern of the mass relations to the adjacent structures. Objective: To correlate the radiographic findings with the computed tomography findings in mediastinal masses at St. Paul's Hospital Millennium Medical College. Methods: A retrospective cross-sectional study was conducted at St. Paul's Hospital including 55 patients with mediastinal masses who underwent both chest X-ray and chest CT scan between January and December 2023. Data entry was performed using Epi-Info version 3.5.1, and analysis utilized SPSS version 23.0. The study employed descriptive statistics and Pearson correlation to compare chest X-ray and CT findings for an overall assessment of mediastinal masses Result: This study was conducted on 55 patients consisting of 29 (52.7%) men and 26 (47.3%) women. Chest x-ray were diagnosed 44 (80%) out of 55 patients, 11 (20%) patient chest out of the 55 patient were not detected in chest x-ray, while chest CT scan were diagnosed 55 out of 55 patients of our study. regarding compartmental distribution of mediastinal masses 35 out of 44 patients were diagnosed chest x-ray are localized showed that the anterior mediastinal masses were the most common lesions 57%, followed by middle mediastinal masses 25%, posterior 11% and multiple 7% while compartmental distribution of mediastinal masses on CT scan showed that anterior mediastinum formed the majority of total masses, 34 (61.8%) followed by middle compartments, 15 (23.6.0%), posterior mediastinum, 5(9.1.0%) and multiple 3 (5.5%).The study established significant correlations between chest X-ray and CT in mass detection (P = 0.01) and compartment localization (P = 0.00), underscoring the complementary role of both modalities for a thorough evaluation. The sensitivity of CT in detecting anterior, middle, posterior and multiple were 61.8%, 23.6%, 9.1%and 5.5%respectively. The overall CT sensitivity for diagnosis of mediastinal masses were appears 100.0%. And the overall chest x-ray sensitivity for diagnosis of mediastinal masses were appears 70.9%. Conclusion There was a significant correlation between chest x-ray detection and x-ray localized of mediastinal masses with chest CT. Regarding sensitivity chest CT was superior and more sensitive to chest x-ray in terms of detection, localization, and characterization of the mediastinal masses. Over all, the most common location detected was anterior mediastinal mass in both chest CT and X-ray, while lymphoma and thymic masses were the most common anterior mediastinal masses.