Role of MRI Diffusion in Assessment of Malignant Mediastinal Masses
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- Category: Vol. 85, June 2017
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Role of MRI Diffusion in Assessment of Malignant Mediastinal Masses, YOUSSRIAH Y. SABRI, TAKEYA TAYMOUR, MOUSTAFA KHAIRY, MARWA MOAWAD and HEBA KHAFAGY
Abstract
Background: Diffusion MR imaging is a non-invasive functional imaging technique that can be incorporated into routine morphological MR examination to provide functional assessments of mediastinal lesions. It can be used for assess-ment of malignant mediastinal masses, differentiating benign from malignant masses as well as staging of central bron-chogenic carcinoma. This method is an excellent alternative to PET/CT in the assessment of malignant mediastinal masses.
Patients and Methods: This study included 23 patients; 13 males and 10 females in the period from June 2013 to July 2014. The mean age was 53.3±16.7 (range: 22-82 years). Cases were referred from the Chest and Oncology Departments to Radiology Department in Kasr El-Aini Hospital for MRI assessment. The complaints varied between dyspnea, chest pain, cough, hemoptysis, fatigue and loss of weight. A super-conducting 1.5 T MRI machine with a four-channel body phased-array coil was used for the examination. Biopsy and histopathological assessment was done after that.
Results: MRI examination with diffusion weighted imaging was able to detect malignant mediastinal masses. The all showed restricted diffusion with the mean ADC for untreated bronchogenic carcinoma was 0.9±0.44 X 10–3mm2/s, for lymphoma was 1.22±0.23 X 10–3mm2/s, for thymoma was 1.24±0.2 X 10–3mm2/s. DWI was able to stage central bron-chogenic carcinoma and differentiate the central mass from the post obstructive collapse where the central mass showed lower ADC value than the post obstructive collapse. The untreated cases of bronchogenic carcinoma showed more diffusion restriction and lower ADC value than the treated cases.
Conclusion: MRI with diffusion weighted images can detect malignant mediastinal masses, detect and stage lung cancer as well as differentiate central bronchogenic carcinoma from post obstructive collapse.