Abstract: 【Abstract】 Objective To determine the enhancement patterns and anatomic distribution of enlarged mediastinal lymph nodes using contrast-enhanced multi-detector CT (MDCT) in patients with sarcoidosis. Methods We reviewed the contrast-enhanced MDCT features of 39 patients with pathologically or clinically diagnosed sarcoidosis, including the size, morphology, attenuation, enhancement patterns, and anatomic distribution of the enlarged mediastinal lymph nodes. Results Of the 39 patients, 85% showed homogenous enhancement and 15% showed homogenous mixed with peripheral enhancement. The enlarged lymph nodes were predominantly distributed in the regions of 10R (95%), 10L (90%), 2R (69%), 7 (69%), and 5 (58%). Conclusion Contrast-enhanced MDCT can detect the enhancement patterns and predominant anatomic distribution of enlarged mediastinal lymph nodes, which is of great value for the diagnosis of sarcoidosis.