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A Multimodality Approach to Imaging the Mediastinum and Pleura: Pearls and Pitfalls

Description Diagnostic interpretation of cross-sectional imaging of the mediastinum and pleura presents unique and significant challenges even to the experienced radiologist. The mediastinum is anatomically complex, comprising numerous structures ar-ranged into multiple anatomic compartments that can give rise to a wide range of pathologies. The pleural space is thin and multi-planar, which can confound evaluation and quantification of pleural abnormalities. In this article, we will review imaging approaches to the mediastinum and pleura and present imaging pearls and pitfalls that can assist radiologic interpretation. This will include common masses that present in routine imaging of the chest and key imaging features that help to distinguish them using CT, MRI and FDG-PET/CT. The knowledge of common mediastinal and pleural pathologies present on cross-sectional imaging will enable the radiologist to make informed diagnostic radiologic interpretations and guide appropriate intervention and surveillance.