title: Infectious mediastinitis after cardiovascular surgery: role of computed tomography.
abstract: 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.
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan. clatsune@yahoo.co.jp
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Yamashiro
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kamiya
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
authors.forename: Shinobu
authors.initials: S
authors.lastname: Unten
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakayama
authors.forename: Masaki
authors.initials: M
authors.lastname: Gibo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kuniyoshi
mesh_terms: 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