The Differentiation of Mediastinal Tumour and Aneurysm: Value of Angiocardiography

Abstract

The value of angiocardiography as an effective method for differentiating aneurysms from other space-occupying lesions of the thorax is illustrated by 4 cases: an extracardiac dermoid cyst with calcified margins simulating aneurysm of the ascending aorta; a saccuiar aneurysm with pulsation prevented by thrombus formation; an aneurysm of the descending aorta and a left lower lobe atelectasis produced by it; and 2 aneurysms one of which was not filled probably because of its small orifice. Visualization of the intact cardiovascular structures in patients with mediastinal masses rules out the presence of aneurysm, whereas opacification of a sacculat-ed or fusiform structure is pathognomic of aneurysm. Rarely, aneurysms with narrowed channels or completely clotted lumina may not opacify. In such instances it may be helpful to find collateral evidence of aortic abnormality.