MRI and CT in the differential diagnosis of pleural disease.
OBJECTIVE
To explore the role of MRI in the differential diagnosis of pleural disease.


METHODS
Forty-two patients with pleural disease were included.


METHODS
Retrospective study. All patients were examined with both CT and MRI. The morphologic features of pleural lesions and magnetic resonance signal intensity on T1-weighted, T2-weighted, and contrast-enhanced T1-weighted images were evaluated.


RESULTS
Mediastinal pleural involvement, circumferential pleural thickening, nodularity, irregularity of pleural contour, and infiltration of the chest wall and/or diaphragm were most suggestive of a malignant cause both on CT and MRI. Pleural calcification on CT was suggestive of a benign cause. Contrary to what has been previously reported in the literature, neither on CT nor on MRI, pleural thickness >1 cm revealed significant difference between malignant and benign pleural disease (p>0.05, chi(2) test). High signal intensity in relation to intercostal muscles on T2-weighted and/or contrast-enhanced T1-weighted images was significantly suggestive for a malignant disease. Using morphologic features in combination with the signal intensity features, MRI had a sensitivity of 100% and a specificity of 93% in the detection of pleural malignancy.


CONCLUSIONS
When signal intensity and morphologic features are assessed, MRI is more useful and therefore superior to CT in differentiation of malignant from benign pleural disease.
Hierholzer
J
J
Klinik und Poliklinik für Strahlenheilkunde, Charité Virchow-Klinikum, Humboldt Universitat zu Berlin, Germany.
Luo
L
L
Bittner
R C
RC
Stroszczynski
C
C
Schröder
R J
RJ
Schoenfeld
N
N
Dorow
P
P
Loddenkemper
R
R
Grassot
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology; D010995:Pleural Diseases / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed