Luo L, Hierholzer J, Bittner R C, Chen J, Huang L
Medical Imaging Center, First Affiliated Hospital, Jinan University Medical College, Guangzhou 510630, China.
Chin Med J (Engl). 2001 Jun;114(6):645-9.
To explore the role of magnetic resonance imaging (MRI) in distinguishing malignant from benign pleural disease.
All 64 patients were examined with both computed tomography (CT) and MRI. The morphologic features of pleural lesions and MR signal intensity on T1-weighted, T2-weighted and contrast-enhanced T1-weighted images were evaluated.
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 on CT and MR images. Contrary to what has been reported in the literature, pleural thickness greater than 1 cm either on CT or on MRI did not reveal a significant difference between malignant and benign pleural disease (P > 0.05, chi-square test). Using morphologic features in combination with signal intensity features, MRI had a sensitivity of 98% and a specificity of 92% in the detection of pleural malignancy.
Compared with those on CT, the morphologic features on MRI allowed a mostly equal and in some cases superior detection and evaluation of the spread of pleural disease. In combination with signal intensity and morphologic features, MRI is very useful in distinguishing malignant from benign pleural disease.
探讨磁共振成像（MRI）在鉴别恶性与良性胸膜疾病中的作用。
对64例患者均进行了计算机断层扫描（CT）和MRI检查。评估了胸膜病变的形态学特征以及在T1加权、T2加权和增强T1加权图像上的MR信号强度。
纵隔胸膜受累、胸膜环形增厚、结节状、胸膜轮廓不规则以及胸壁和/或膈肌浸润在CT和MR图像上最提示为恶性病因。与文献报道相反，CT或MRI上胸膜厚度大于1 cm在恶性和良性胸膜疾病之间未显示出显著差异（P>0.05，卡方检验）。结合形态学特征和信号强度特征，MRI在检测胸膜恶性肿瘤方面的敏感性为98%，特异性为92%。
与CT相比，MRI上的形态学特征在检测和评估胸膜疾病的扩散方面大多相当，在某些情况下更具优势。结合信号强度和形态学特征，MRI在鉴别恶性与良性胸膜疾病方面非常有用。
