Roles Of CT And MRI In Differential Diagnosis Of Pleural Disease

Objective: To explore the role of CT and MRI in the differential diagnosis of benign and malignant pleural disease.Material and Methods: Fifty-six cases of pleural disease were examined with CT, 29 cases of them were also examined with MRI and 20 cases were examined with high resolution MRI (HR-MRI) at the same time. In this thesis, the diagnostic value between CT and MRI, ordinary MRI and HR-MRI in the benign and malignant pleural disease were comparatively evaluated.Results: 1 .Examined with CT, the incidence rate of circumferential pleural thickening in the MPM and MPD was56% and 18%, respectively. It revealed significant difference between MPM and MPD (P<0.05). Mediastinal structures involvement, infiltration of the chest wall and/or diaphragm were only observed in the MPM and MPD. The difference of incidence rate of nodular pleural thickening in MPM, MPD and BPD was not significant (P>0.05). 2.Examined with MRI, mediastinal pleural involvement, circumferential pleural thickening, irregularity of pleural contour, diffuse pleural thickening and infiltration of the chest wall and /or diaphragm were significant different between malignant and benign pleural disease (P<0.05). Compared with ordinary MRI, although the HR-MRI had the advantage on displaying the anatomic structure of the chest wall, especially the infiltration of the chest wall in the early stage, the diagnostic values of them on benign and malignant pleural disease were not of statistic significant difference (P>0.05). 3.Using morphologic features in combination with signal intensity features, MR was more superior to CT in differentiation of malignant from benign pleural disease (P<0.05). Conclusion: 1.Examined with CT, circumferential pleural thickening was the most useful feature in distinguishing MPM from MPD. Mediastinal structures involvement, infiltration of the chest wall and/or diaphragm directly suggested malignancy. 2. Combining the morphologic features and signal features, MRI was more helpful fordifferentiation of malignant from benign pleural disease. 3.Compared with ordinary MRI, HR-MRI had advantage on displaying the anatomic structure of chest wall, especially in the detection of malignant chest wall infiltration in the early stage.