[Value of computer tomography in comparison to mediastinoscopy and test thoracotomy in intrathoracic space-occupying lesions with mediastinal involvement].

The preoperative CT findings in 50 patients out of a total of 144 examined patients with suspected intrathoracal malignant processes with mediastinal involvement were compared to the results obtained by mediastinoscopy and thoracotomy. There was a high diagnostical reliability (95%, n = 40) in assessing lesions in the area, which can be reached by mediastinoscopy. This leads to the conclusion that mediastinoscopy is necessary only in such cases with histologically proven malignant intrathoracal masses, which show lymph nodes of a size from 1 to 2 cm. The evidence of invasive extension into adjacent mediastinal structures as well as the distance from tumour to carina could be assessed well by CT. For follow-up examinations after resection, radiation therapy or chemotherapy, computed tomography is of particular value to detect early mediastinal recurrence.