Bittner R C, Schnoy N, Schönfeld N, Grassot A, Loddenkemper R, Lode H, Kaiser D, Krumhaar D, Felix R
Strahlen- und Poliklinik im Universitätsklinikum Rudolf Virchow, Freie Universität Berlin.
Rofo. 1995 Apr;162(4):296-303. doi: 10.1055/s-2007-1015886.
To determine the value of high-resolution MRI in pleural and chest wall diseases, the normal and pathologic costal pleura and adjacent chest wall between paravertebral and the axillary region were examined with contrast enhanced high-resolution T1-weighted MRI images using a surface coil.
Normal anatomy was evaluated in 5 healthy volunteers and a normal specimen of the thoracic wall, and correlation was made with corresponding HR-CT and histologic sections. CT-proved focal and diffuse changes of the pleura and the chest wall in 36 patients underwent HR-MRI, and visual comparison of MRI and CT was done retrospectively.
Especially sagittal T1-weighted HR-MRI images allowed accurate delineation of the peripleural fat layer (PFL) and the innermost intercostal muscle (IIM), which served as landmarks of the intact inner chest wall. PFL and IIM were well delineated in 3/4 patients with tuberculous pleuritis, and in all 7 patients with non-specific pleuritis, as opposed to impairment of the PFL and/or the IIM, which was detected in 15/18 malignancies as a pattern of malignant chest wall involvement. In one case of tuberculous pleural empyema with edema of the inner chest wall HR-MRI produced false positive diagnosis of malignant disease.
HR-MRI images improved non-invasive evaluation of pleural and chest wall diseases, and allowed for differentiation of benign and malignant changes.
为了确定高分辨率磁共振成像（MRI）在胸膜和胸壁疾病中的价值，使用表面线圈，通过对比增强高分辨率T1加权MRI图像对椎旁和腋窝区域之间的正常和病理肋胸膜及相邻胸壁进行检查。
对5名健康志愿者和1个胸壁正常标本的正常解剖结构进行评估，并与相应的高分辨率计算机断层扫描（HR-CT）和组织学切片进行对比。对36例经CT证实胸膜和胸壁有局灶性和弥漫性改变的患者进行了HR-MRI检查，并对MRI和CT进行回顾性视觉比较。
尤其是矢状面T1加权HR-MRI图像能够准确勾勒出胸膜周围脂肪层（PFL）和最内层肋间肌（IIM），它们是完整胸壁内层的标志。在3/4的结核性胸膜炎患者和所有7例非特异性胸膜炎患者中，PFL和IIM均清晰可辨，相反，在18例恶性肿瘤中的15例中检测到PFL和/或IIM受损，表现为恶性胸壁受累模式。在1例伴有胸壁内层水肿的结核性胸腔积脓病例中HR-MRI对恶性疾病产生了假阳性诊断。
HR-MRI图像改善了对胸膜和胸壁疾病的无创评估，并有助于区分良性和恶性病变。
