title: MRI differentiation of pneumonia-like mucinous adenocarcinoma and infectious pneumonia.
abstract: OBJECTIVE
  To evaluate the role of MRI water-sensitive sequences in the differential diagnosis between pneumonia-like mucinous adenocarcinoma and infectious pneumonia.
  
  
  METHODS
  Twenty-three patients with pneumonia-like mucinous adenocarcinoma and 30 patients with infectious pneumonia underwent computed tomography (CT) and MRI. Two blinded and independent readers evaluated CT and MR images using a 3-level confidence scale in two separate sessions. Results were tested for statistical significance using the Fisher's exact test and the Cohen's k test.
  
  
  RESULTS
  On CT, the two readers respectively made correct diagnoses of mucinous adenocarcinoma in 17 out of 23 cases (73.9%), and in 15 out of 23 cases (65.2%). A correct diagnosis of infectious pneumonia was made in 22 out of 30 cases (73.3%), and in 24 out of 30 cases (80.0%). On MRI, both readers made correct diagnoses of mucinous adenocarcinoma in 23 out of 23 (100%) cases, and of infectious pneumonia in 30 out of 30 (100%) cases. Fisher's exact test showed a significant difference in the diagnosis of mucinous adenocarcinoma between MRI and CT for both readers, P=0.01 for reader 1 and P=0.002 for reader 2, respectively. A good agreement (k=0.73) was found between the two readers on CT evaluation, whereas an almost perfect agreement (k=1.00) was found for MRI.
  
  
  CONCLUSIONS
  MRI with "water-sensitive" sequences should be added in the diagnostic protocol of every patient with pulmonary consolidation suspected to be mucinous adenocarcinoma.
authors.affiliation: Department of Radiological Sciences, Policlinico G. Martino, Via Consolare Valeria 1, 98100 Messina, Italy. gaesam@hotmail.it
authors.forename: Michele
authors.initials: M
authors.lastname: Gaeta
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ascenti
authors.forename: Silvio
authors.initials: S
authors.lastname: Mazziotti
authors.forename: Rosario
authors.initials: R
authors.lastname: Contiguglia
authors.forename: Mario
authors.initials: M
authors.lastname: Barone
authors.forename: Achille
authors.initials: A
authors.lastname: Mileto
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity