What is the role of chest CT scanning in the diagnosis of pneumomediastinum (PM)?

Updated: Feb 26, 2019
  • Author: Patrick L Carolan, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Chest CT scanning has 2 major roles in the diagnosis of pneumomediastinum.

Chest CT scanning may be used to diagnose pneumomediastinum not visualized on chest radiography. A study from Japan describes the use of chest CT scanning in diagnosing small pneumomediastinum not visible on chest radiography. In a series of 33 patients diagnosed with spontaneous pneumomediastinum (SPM) on the basis of clinical presentation and/or chest radiography findings, chest CT scanning revealed pneumomediastinum in 3 patients in whom the chest radiography findings were unremarkable. The authors concluded that chest radiography alone may result in a missed diagnosis in 10% of patients presenting with pneumomediastinum. In a series of 20 patients with SPM and evidence of mediastinal air collections on chest CT, chest radiographs were interpreted as normal in 20% (Okada 2014).

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