The value of MRI in the differential diagnosis of pleural tumor / 中华放射学杂志

ABSTRACT

Objective To explore the role of MR imaging (MRI) in the differential diagnosis of pleural tumor. Methods Forty five cases of pleural tumor (8 benign and 37 malignant) were examined with both CT and MRI. The morphologic features of pleural lesions and MR signal intensity on T 1 weighted, T 2 weighted, and contrast enhanced T 1 weighted images were evaluated. Results On CT images, it was found that 30 cases were with diffuse pleural thickening (29 malignant and 1 benign), 28 with mediastinal pleural involvement (27 malignant and 1 benign), 23 with circumferential or irregular pleural thickening (22 malignant and 1 benign), and 9 with infiltration of the chest wall or diaphragm (only in malignant patients). On MR images, it was found that 32 cases were with diffuse pleural thickening (31 malignant and 1 benign), 29 with mediastinal pleural involvement (27 malignant and 2 benign), 24 with circumferential or irregular pleural thickening (23 malignant and 1 benign), and 11 with infiltration of the chest wall or diaphragm (only in malignant patients). According to the above mentioned morphologic features, CT had a sensitivity of 83.8% and a specificity of 62.5% in the detection of pleural malignancy, as compared to 86.5% and 62.5% by MRI, respectively. In combination with signal intensity and morphologic features, MRI had a sensitivity of 97.3% and aspecificity of 100% in the detection of pleural malignancy. Conclusion According to the morphological features only, MRI allowed a similar value in the detection and diagnosis of pleural tumor compare with CT. In combination with signal intensity and morphologic features, MRI is more useful and, therefore, superior to CT in differentiation of malignant from benign pleural tumor.