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European Radiology

, Volume 7, Issue 6, pp 860–864 | Cite as

Transudative vs exudative pleural effusions: differentiation using Gd-DTPA-enhanced MRI

  • C. Frola
  • S. Cantoni
  • I. Turtulici
  • C. Leoni
  • F. Loria
  • M. Gaeta
  • L. E. Derchi
Original article

Abstract.

The aim of this study was to investigate the capability of Gd-DTPA-enhanced MRI to differentiate between exudative and transudative pleural effusions. An MRI examination was performed on 22 patients with different types of pleural effusion (10 transudative and 12 exudative effusions). T1-weighted SE images were obtained before and 20 min after administration of Gd-DTPA (0.1 mmol/kg). The degree of enhancement of pleural effusions was evaluated both by visual assessement and by quantitative analysis of images. None of 10 transudative effusions showed significative enhancement, whereas 10 of 12 exudative effusions showed enhancement (sensitivity 83 %, specificity 100 %, positive predictive value 100 %). The postcontrast signal intensity ratios (SIRs) of exudates were significantly higher than corresponding precontrast ratios (P = 0.0109) and the postcontrast SIRs of exudates were significantly higher than those of transudates (P = 0.0300). Exudative pleural effusions show a significant enhancement following administration of Gd-DTPA. We presume that this may be caused by increased pleural permeability and more rapid passage of a large amount of Gd-DTPA from the blood into the pleural fluid in case of exudative effusions. In our limited group of patients, signal enhancement proved the presence of an exudative effusion. Absence of signal enhancement suggests a transudate, but does not exclude an exudate.

Key words: Pleura Effusion Exudates Transudates MRI Gd-DTPA 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • C. Frola
    • 1
  • S. Cantoni
    • 1
  • I. Turtulici
    • 1
  • C. Leoni
    • 2
  • F. Loria
    • 1
  • M. Gaeta
    • 3
  • L. E. Derchi
    • 4
  1. 1.IV Divisione Radiologica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova, ItalyIT
  2. 2.Divisione di Chirurgia Toracica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova, ItalyIT
  3. 3.Servizio di Radiologia, Ospedale Piemonte, I-98100 Messina, ItalyIT
  4. 4.Cattedra di Radiologia, Universita` degli Studi, V. le Benedetto XV, 10, I-16132 Genova, ItalyIT

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