Mass lesions in the chest can usually be best evaluated by conventional means, primarily plain chest film examination. Fluoroscopy is often useful, especially to differentiate normal thymus from abnormal anterior mediastinal masses and to evaluate possible vascular masses. It makes sense to do a barium swallow for most middle mediastinal masses before resorting to the more expensive CT or MRI. In addition to the added expense, the marked increase in radiation dose should also be considered when CT is contemplated.
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