Advanced

Dynamic Contrast-Enhanced MR Imaging for Differentiation of Rounded Atelectasis From Neoplasm

Horn, Michael; Oechsner, Markus; Gardarsdottir, Marianna; Koestler, Herbert and Müller, Markus LU (2010) In Journal of Magnetic Resonance Imaging 31(6). p.1364-1370
Abstract
Purpose: To characterize rounded atelectasis (RA) with dynamic contrast-enhanced MRI in the differential diagnosis of solitary peripheral pulmonary neoplasm. Materials and Methods: Twenty-four patients with diagnostically equivocal peripheral pulmonary nodules were examined with dynamic contrast-enhanced MRI. 13 patients had a total of 16 rounded atelectases and 11 had a neoplasm. The final diagnosis was made either by histology (n = 14) or follow-up examinations of at least 24 months (n = 10). The peripheral nodules were evaluated concerning their morphology and contrast-enhancement dynamics. Curves for signal intensity (SI) versus time were produced and the relative increase in SI, slope of SI during wash-in, and slope of SI during... (More)
Purpose: To characterize rounded atelectasis (RA) with dynamic contrast-enhanced MRI in the differential diagnosis of solitary peripheral pulmonary neoplasm. Materials and Methods: Twenty-four patients with diagnostically equivocal peripheral pulmonary nodules were examined with dynamic contrast-enhanced MRI. 13 patients had a total of 16 rounded atelectases and 11 had a neoplasm. The final diagnosis was made either by histology (n = 14) or follow-up examinations of at least 24 months (n = 10). The peripheral nodules were evaluated concerning their morphology and contrast-enhancement dynamics. Curves for signal intensity (SI) versus time were produced and the relative increase in SI, slope of SI during wash-in, and slope of SI during wash-out calculated. Additionally, SI time curves were evaluated using a two compartment model where the ratio for the SI of the fast and the slow component were calculated. Mean values from different tissues of interest were compared by an unpaired two-sided t-test. Results: Analysis of the SI-time curves of the RAs revealed a curve shape similar to the pulmonary artery, but a magnitude in SI between artery and normal lung tissue. Linear curve fit showed a significantly steeper slope during wash-in and wash-out, and higher relative signal increase in atelectases as compared to neoplasms. Results from the two compartment model showed increased flow and a high ratio of the slow to the fast components with a long mean transit time in neoplasms. Conclusion: Three parameters, slope of SI during wash-in and wash-out, and the slow/fast ratio can be used as diagnostic tools for discrimination of RA and neoplasm. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
differential diagnosis, pleural disease, dynamic contrast-enhanced imaging, neoplasm, MRI, rounded atelectasis
in
Journal of Magnetic Resonance Imaging
volume
31
issue
6
pages
1364 - 1370
publisher
John Wiley & Sons
external identifiers
  • wos:000278174300009
  • scopus:77952837459
ISSN
1522-2586
DOI
10.1002/jmri.22176
language
English
LU publication?
yes
id
3f4d19f5-58c7-4584-a395-a8ce39dc7dcc (old id 1631872)
date added to LUP
2010-07-22 12:42:18
date last changed
2018-05-29 12:04:09
@article{3f4d19f5-58c7-4584-a395-a8ce39dc7dcc,
  abstract     = {Purpose: To characterize rounded atelectasis (RA) with dynamic contrast-enhanced MRI in the differential diagnosis of solitary peripheral pulmonary neoplasm. Materials and Methods: Twenty-four patients with diagnostically equivocal peripheral pulmonary nodules were examined with dynamic contrast-enhanced MRI. 13 patients had a total of 16 rounded atelectases and 11 had a neoplasm. The final diagnosis was made either by histology (n = 14) or follow-up examinations of at least 24 months (n = 10). The peripheral nodules were evaluated concerning their morphology and contrast-enhancement dynamics. Curves for signal intensity (SI) versus time were produced and the relative increase in SI, slope of SI during wash-in, and slope of SI during wash-out calculated. Additionally, SI time curves were evaluated using a two compartment model where the ratio for the SI of the fast and the slow component were calculated. Mean values from different tissues of interest were compared by an unpaired two-sided t-test. Results: Analysis of the SI-time curves of the RAs revealed a curve shape similar to the pulmonary artery, but a magnitude in SI between artery and normal lung tissue. Linear curve fit showed a significantly steeper slope during wash-in and wash-out, and higher relative signal increase in atelectases as compared to neoplasms. Results from the two compartment model showed increased flow and a high ratio of the slow to the fast components with a long mean transit time in neoplasms. Conclusion: Three parameters, slope of SI during wash-in and wash-out, and the slow/fast ratio can be used as diagnostic tools for discrimination of RA and neoplasm.},
  author       = {Horn, Michael and Oechsner, Markus and Gardarsdottir, Marianna and Koestler, Herbert and Müller, Markus},
  issn         = {1522-2586},
  keyword      = {differential diagnosis,pleural disease,dynamic contrast-enhanced imaging,neoplasm,MRI,rounded atelectasis},
  language     = {eng},
  number       = {6},
  pages        = {1364--1370},
  publisher    = {John Wiley & Sons},
  series       = {Journal of Magnetic Resonance Imaging},
  title        = {Dynamic Contrast-Enhanced MR Imaging for Differentiation of Rounded Atelectasis From Neoplasm},
  url          = {http://dx.doi.org/10.1002/jmri.22176},
  volume       = {31},
  year         = {2010},
}