How is spontaneous pneumomediastinum differentiated from secondary pneumomediastinum on chest CT?

Updated: Feb 26, 2019
  • Author: Patrick L Carolan, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Answer

Ho et al [33] report a series comparing the radiologic findings of patients diagnosed with spontaneous pneumomediastinum to those with secondary pneumomediastinum associated with a central airways defect, esophageal rupture, or recent intervention in the airway or esophagus. They note that on multidetector CT (MDCT), spontaneous pneumomediastinum patients were more likely to have air in the anterior mediastinum (97% vs 61%, P< .001) and pulmonary interstitial emphysema (57% vs 4%, P< .001) and less likely to show subdiaphragmatic air (0% vs 32%, P< .001), pleural effusions (9% vs 61%, P< .001), and acute pulmonary airspace opacities (14% vs 50%, P = .003) when compared with patients with secondary pneumomediastinum.


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