Key Points

• Contrast enhanced CT is the most important imaging modality in the assessment of mediastinal masses.
• MRI is superior to CT in the evaluation of tumor involvement of the great vessels and spine and in differentiating vascular, solid, and cystic lesions.
• FDG-PET imaging, particularly when combined with CT (PET-CT) imaging, is helpful in the staging of lymphoma and in the follow-up of patients with lymphoma and other malignant mediastinal tumors.

Imaging plays an important role in the detection and management of mediastinal disease. The various imaging modalities currently available provide excellent depiction of the mediastinum and its abnormalities. They have high sensitivity in the detection of mediastinal lesions and in determining their relationship to adjacent structures. Each of the various imaging modalities, however, has inherent limitations. The aim of this chapter is to review the characteristic imaging manifestations of the most common mediastinal abnormalities and to outline the role and limitations of imaging.