Magnetic resonance imaging in distinguishing malignant from benign pleural disease

Objective To explore the role of magnetic resonance imaging (MRI) in distinguishing malig nant from benign pleural disease.Methods All 64 patients were examined with both computed tomography (CT) and MRI. The m orphologic features of pleural lesions and MR signal intensity on T1-weighted, T2-weighted and contrast-enhanced T1-weighted images were evaluated.Results Mediastinal pleural involvement, circumferential pleural thickening, no dularity, irregularity of pleural contour, and infiltration of the chest wall an d/or diaphragm were most suggestive of a malignant cause on CT and MR images. C ontrary to what has been reported in the literature, pleural thickness greater t han 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 se nsitivity of 98% and a specificity of 92% in the detection of pleural malignancy . Conclusions Compared with those on CT, the morphologic features on MRI allowed a mostly equ al and in some cases superior detection and evaluation of the spread of pleur al disease. In combination with signal intensity and morphologic features, MRI is very useful in distinguishing malignant from benign pleural disease.