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6. Neurogenic tumor. T2-weighted tranverse MRI shows a posterior mediastinal mass. Ganglioneuroma confirmed at surgery 24 Vascular Abnormalities Vascular anomalies of the mediastinum can occasionally be confused with mediastinal masses on plain film. Cross-sectional imaging is helpful in diagnosing them but the clinician must be well-acquainted with these entities to avoid propagating the confusion. Tortuous vessels are perhaps the most common mediastinal vascular abnormality confused with mass on chest radiography.

Breathing During the Scan Ideally, scans should be performed in suspended inspiration at total lung capacity, but this is not often possible in the younger patients. Experience has proved that quiet breathing is more successful than the confusion created over attempts to acquire the scans in suspended inspiration [4]. When subtle air-trapping due to small airways disease is suspected, a few supplementary expiratory sections may be obtained. If the child is too young to breath-hold, decubitus scans may replace expiratory scans, the dependent lung behaving as the ‘expiratory’ lung and the non-dependent lung behaving as the ‘inspiratory’ lung [4].

Ganglioneuroma confirmed at surgery 24 Vascular Abnormalities Vascular anomalies of the mediastinum can occasionally be confused with mediastinal masses on plain film. Cross-sectional imaging is helpful in diagnosing them but the clinician must be well-acquainted with these entities to avoid propagating the confusion. Tortuous vessels are perhaps the most common mediastinal vascular abnormality confused with mass on chest radiography. The right innominate artery (causing a right paratracheal opacity) and the left superior intercostal vein are two of the more common enlarged, tortuous variants [11].

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