title: Location, size, and distribution of mediastinal lymph node enlargement in chronic congestive heart failure.
abstract: OBJECTIVE
  The purpose of this study is to identify the prevalence, location, and size of enlarged mediastinal lymph nodes in patients with chronic congestive heart failure and to correlate the presence of lymph node enlargement with cardiac ejection fraction.
  
  
  METHODS
  Sixty-six consecutive, retrospectively identified patients underwent computer tomography (CT) imaging of the thorax as part of a routine work-up prior to cardiac transplantation from 1993 to 1996. CT images of 44 of these patients were independently examined by 3 radiologists for evidence of pulmonary edema, pleural effusions, and the presence, size, and location of lymph nodes >1 cm in short axis. Multigated acquisition (MUGA) scans were available for cardiac ejection fraction assessment in 38 of the 44 patients.
  
  
  RESULTS
  Twenty-nine (66%) patients had at least 1 mediastinal lymph node >1 cm. The mean ejection fraction was significantly less for patients with lymph node enlargement when compared with patients without lymph node enlargement (20% versus 35%; P < 0.01). Adenopathy was observed in 81% of patients with a calculated ejection fraction of <35%. No patient with an ejection fraction of >35% had lymph node enlargement. There was no correlation between pulmonary edema and the frequency of lymph node appearance. Sixty-three percent of the enlarged nodes were pretracheal, with a mean short axis diameter for all the enlarged nodes of 1.3 cm.
  
  
  CONCLUSIONS
  Enlarged mediastinal lymph nodes were observed in 81% of patients with a calculated ejection fraction of <35%, most commonly in the pretracheal group. The presence of the lymph nodes did not correlate with CT evidence of pulmonary edema.
authors.affiliation: Department of Radiology, College of Medicine, The University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724-5067, USA. klarka@radiology.arizona.edu
authors.forename: William K
authors.initials: WK
authors.lastname: Erly
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Borders
authors.forename: Eric K
authors.initials: EK
authors.lastname: Outwater
authors.forename: Julie M
authors.initials: JM
authors.lastname: Zaetta
authors.forename: Guy T
authors.initials: GT
authors.lastname: Borders
mesh_terms: D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D008482:Mediastinum; D015995:Prevalence; D012189:Retrospective Studies; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed