CT analysis of the anterior mediastinal fat: before and after lobectomy

CT analysis was performed to evaluate change in the anterior mediastinal fat (AMF) after lobectomy and differences in AMF in the lobectomized region. In 67 carcinoma patients who underwent lobectomy, the area and volume of AMF were measured on CT before and after surgery. Mediastinal deviation after lobectomy was also correlated to the altered fat tissue. The postoperative AMF distribution was distinctly changed in the left upper lobectomy (LUL) group, showing a marked increase from the infra-aortic arch to the carina level, with converse decreases in upper and lower slices. No significant post-operative change was noted in total AMF volume. There was a close correlation between changes in AMF area and mediastinal deviation after lobectomy, and postoperative mediastinal deviation was also greater the in the LUL group than in any other group. In conclusion, postoperative change in the AMF area was distinctly different in the LUL group. Redistribution of displaced AMF is considered to be the main cause of seemingly increased fat tissue.