[Three-dimensional dynamic MR imaging with a volumetric interpolated breath-hold examination for solitary pulmonary lesions: correlation of contrast enhancement pattern with pathological features].
OBJECTIVE
To evaluate the clinical feasibility of dynamic MR imaging of solitary pulmonary lesions (SPLs) using a fat-suppressed three-dimensional gradient-echo technique with a volumetric interpolated breath-hold examination (VIBE). Correlation between the enhancement pattern and the histological characteristics of the nodules was also assessed.


METHODS
Dynamic 3D-VIBE was performed in 16 patients with pathologically proven SPLs. Each lesion was analyzed for its internal enhancement pattern, dynamic enhancement pattern, and peripheral enhancement (PE).


RESULTS
A heterogeneous pattern of internal enhancement was well correlated with histological observation of necrosis, cystic changes, and variously sized air spaces. The washout pattern was seen in the medullary parts of the nodules with little fibrous stroma. The progressive pattern was seen at foci of collapse in the alveolar structure, central scars, and prominent fibrosis. PE was also seen in 6 malignant lesions (43%), and was well correlated with the medullary growth of adenocarcinoma and marginal fibrosis with lymphocytic infiltration of squamous cell carcinoma. The presence of PE was statistically significantly related with tumor size (p < 0.05).


CONCLUSIONS
Dynamic 3D-VIBE allows assessment of the histological characteristics of SPLs. It is also thought that this technique may be a promising method for differentiation between benign and malignant lesions.
Department of Radiology, Daisan Hospital, Jikei University School of Medicine.
Mitsuhiro
M
Tozaki
Masafumi
M
Suzuki
Hiroshi
H
Takeda
Hisakazu
H
Tai
Jun
J
Asakura
Isao
I
Miyoshi
Hiroyuki
H
Katou
Masaharu
M
Fukunaga
Kouichirou
K
Naruo
Yasushi
Y
Fukuda
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D017352:Echo-Planar Imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014375:Tuberculoma / Q000175:diagnosis / Q000473:pathology