Study objective: To explore the role of MRI in the
differential diagnosis of pleural disease.
Forty-two patients with pleural disease were included.
Method: Retrospective study. All patients were examined
with both CT and MRI. The morphologic features of pleural lesions and
magnetic resonance signal intensity on T1-weighted, T2-weighted, and
contrast-enhanced T1-weighted images were evaluated.
Results: 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 both on CT and MRI. Pleural calcification on CT was
suggestive of a benign cause. Contrary to what has been previously
reported in the literature, neither on CT nor on MRI, pleural thickness>
1 cm revealed significant difference between malignant and benign
pleural disease (p > 0.05, χ2 test). High signal
intensity in relation to intercostal muscles on T2-weighted and/or
contrast-enhanced T1-weighted images was significantly suggestive for a
malignant disease. Using morphologic features in combination with the
signal intensity features, MRI had a sensitivity of 100% and a
specificity of 93% in the detection of pleural malignancy.
Conclusion: When signal intensity and morphologic features
are assessed, MRI is more useful and therefore superior to CT in
differentiation of malignant from benign pleural