Evaluation of pleural disease using MR and CT. With special reference to malignant pleural mesothelioma.
OBJECTIVE
To evaluate MR imaging and CT in differentiating malignant pleural mesothelioma from other malignancies or benign pleural disease.


METHODS
Thirty-four patients (18 pleural mesotheliomas, 9 other malignancies, 7 benign pleural diseases) were examined using enhanced CT and MR. Two radiologists reviewed the CT and two others the MR images. Comparisons were made between the diagnostic groups and the imaging methods.


RESULTS
The abnormalities commonly found in malignant disease, but significantly less frequently in benign pleural disease, were focal thickening and enhancement of interlobar fissures. In mesothelioma, enhancement of interlobar fissures, tumour invasion of the diaphragm, mediastinal soft tissue or chest wall, were significantly more often observed than in other malignancies and MR was the most sensitive method. In other malignancies, invasion of bony structures was a more common finding and was also better shown by MR. The contrast-enhanced T1 fat-suppressed (CET1fs) sequence detected these features better than other MR sequences.


CONCLUSIONS
MR, especially the CET1fs sequence in three planes, gave more information than enhanced CT. Focal thickening and enhancement of interlobar fissures were early abnormalities indicating malignant pleural disease. MR could be clinically useful for differentiating mesothelioma from other pleural diseases.
Knuuttila
A
A
Department of Medicine, Division of Respiratory Disease, Helsinki University Central Hospital, Helsinki, Finland.
Kivisaari
L
L
Kivisaari
A
A
Palomäki
M
M
Tervahartiala
P
P
Mattson
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology; D010995:Pleural Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed