Can diffusion weighted MRI differentiate between inflammatory-infectious and malignant pleural effusions?

Authors

  • O. Karatag Department of Radiology, Canakkale Onsekiz Mart University School of Medicine.
  • T. Alar Department of Thoracic Surgery, Canakkale Onsekiz Mart University, School of Medicine.
  • S. Kosar Department of Radiology, Canakkale Onsekiz Mart University School of Medicine.
  • G. Ocakoglu Department of Biostatistics, Uludag University, Shool of Medicine.
  • Y. Yildiz Department of Radiology, Canakkale Onsekiz Mart University School of Medicine.
  • E. Gedik Department of Thoracic Surgery, Canakkale Onsekiz Mart University, School of Medicine.
  • U. Gonlugur Department of Chest Diseases, Canakkale Onsekiz Mart University, School of Medicine.
  • H. Ozdemir Department of Radiology, Canakkale Onsekiz Mart University School of Medicine.

DOI:

https://doi.org/10.5334/jbr-btr.767

Keywords:

Lung, effusion – Lung, MR – Magnetic resonance (MR), diffusion study.

Abstract

Aim: To assess exudative pleural effusions with diffusion-weighted magnetic resonance imaging (DW-MRI) in order to determine non-invasive differentiation criteria for inflammatory-infectious and malignant effusions. Materials and methods: Thirty-two patients with pleural effusions underwent DW-MRI with 4 different b values (10, 500, 750 and 1000 s/mm2). ADC maps were generated automatically. Signal intensity and ADC values were measured. Following MRI, pleural fluid of 10-15 ml was obtained and analyzed. AUC values were compared for different diffusion levels of ADC and SI measurements. The relationship between ADC values and pleural effusion LDH and total protein levels was examined. Results: The cut-off values obtained from signal intensity and ADC measurements to differentiate exudates with malignant pathology were not found to be statistically significant. In the inflammatory-infectious group, a significant negative correlation was observed between ADC values and pleural fluid LDH measurements in all b values. In the malignant group, a significant positive correlation was observed between ADC values and pleural fluid total protein measurements in b values of 500 and 1000. Conclusion: Infectious/inflammatory and malignant effusions overlap strongly and cannot therefore be differentiated using DW MRI.

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Published

2015-04-01

Issue

Vol. 98 No. 2 (2015)

Section

Original Article

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