Magnetic resonance imaging in distinguishing malignant from benign pleuraldisease

Objective To explore the role of magnetic resonance imaging (MRI) in distin guishing malignant from benign pleural disease. Methods All 64 patients were examined with both computed tomography (CT) an d MRI. The morphologic features of pleural lesions and MR signal intensity on T1-weighted, T2-weighted and contrast-enhanced T1-weighted images were e valuated. Results Mediastinal pleural involvement, circumferential pleural thickening , nodularity, irregularity of pleural contour, and infiltration of the ches t wall and/or diaphragm were most suggestive of a malignant cause on CT and MR images. Contrary to what has been reported in the literature, pleural t hickness greater than 1 cm either on CT or on MRI did not reveal a signific ant difference between malignant and benign pleural disease ( P > 0.05, chi -square test). Using morphologic features in combination with signal intens ity features, MRI had a sensitivity of 98% and a specificity of 92% in the detection of pleural malignancy. Conclusions Compared with those on CT, the morphologic features on MRI allo wed a mostly equal and in some cases superior detection and evaluation of t he spread of pleural disease. In combination with signal intensity and morp hologic features, MRI is very useful in distinguishing malignant from benig n pleural disease.