Infectious mediastinitis after cardiovascular surgery: role of computed tomography.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of computed tomography (CT) findings in the diagnosis of mediastinitis after cardiovascular surgery with median sternotomy.


METHODS
A total of 122 patients were divided into two groups: the early group (<or=21 days after surgery) and the late group (>21 days after surgery). Among them, six patients were ultimately diagnosed with infectious mediastinitis. CT findings in each patient were evaluated. Mediastinal fluid collections or free gas bubbles were regarded as the primary findings of mediastinitis.


RESULTS
In the early group, sensitivity and specificity of the primary CT findings were 100% and 39%, respectively. In the late group, the sensitivity was 100% and the specificity 85%. Mediastinal fluid collections were observed in all six patients with mediastinitis.


CONCLUSIONS
Mediastinal fluid collections or free gas bubbles are not specific during the early postoperative period. However, after 2 21 days, these observations could be indicative of mediastinitis.
Yamashiro
Tsuneo
T
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan. clatsune@yahoo.co.jp
Kamiya
Hisashi
H
Murayama
Sadayuki
S
Unten
Shinobu
S
Nakayama
Tadashi
T
Gibo
Masaki
M
Kuniyoshi
Yukio
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000000981:diagnostic imaging*; D013504:Cardiovascular Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013249:Sternum / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed