Dynamic Contrast - Enhanced Magnetic Resonance Imaging (DCE-MRI) in Diagnosis of Pulmonary Nodules

Document Type : Original Article

Authors

The Department of Radiodiagnosis, Faculty of Medicine, Tanta University*, Menshawy Tanta Hospital** and The Department of Chest, Faculty of Medicine, Tanta University***

Abstract

Abstract Background: The differentiation between the benign and malignant pulmonary nodules has been considered as a major challenge for many years. Despite the fact that biopsy and histopathological evaluation are crucial for the definitive diagnosis, recent non-invasive imaging modalities are prom-ising in their results. Aim of Study: The aim of this study is to evaluate the role of Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) in diagnosis of pulmonary nodules. Patients and Methods: This study is a cross-sectional study that has been conducted on 60 patients with lung nodules referred to Radio Diagnosis and Imaging Department from Chest and Oncology Departments through the period from September 2018 to September 2019. Results: There were statistically significant differences between malignant and benign cases in terms of maximum net enhancement (p=0.003) and ADC value (p < 0.001). The mean maximum net enhancement was 474±94.417, the mean washout ratio was 5.45±2.17%, and the mean ADC value was 1.2±0.34 X 10–3mm2/sec. Malignant cases had significantly higher maximum net enhancement, washout ratio, and lower ADC values. The maximum enhancement curve was a signif-icant discriminator, which yielded a sensitivity of 92.6% and specificity of 96% at a cut-off value of ³375. In contrary, the ADC value had poor diagnostic accuracy in differentiating between malignant and benign cases. Conclusion: Dynamic contrast-enhanced MRI is valuable for diagnosis of pulmonary nodules and discrimination of benign from malignant ones.

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