Eur Radiol (2004) 14:890–896 DOI 10.1007/s00330-003-1995-4
T. Baysal T. Bulut M. Gökirmak S. Kalkan A. Dusak M. Dogan
Received: 6 January 2003 Revised: 26 March 2003 Accepted: 15 May 2003 Published online: 1 August 2003 © Springer-Verlag 2003
T. Baysal (✉) · T. Bulut · A. Dusak M. Dogan Department of Radiology, Inönü University School of Medicine, Turgut Özal Medical Center, 44069 Malatya, Turkey e-mail:
[email protected] Tel.: +90-422-3410834 Fax: +90-422-3410834 M. Gökirmak · S. Kalkan Department of Pulmonary Diseases, Inönü University School of Medicine, Turgut Özal Medical Center, 44069 Malatya, Turkey
CHEST
Diffusion-weighted MR imaging of pleural fluid: differentiation of transudative vs exudative pleural effusions
Abstract The aim of this study was to evaluate the ability of diffusionweighted MRI in differentiating transudative from exudative pleural effusions. Fifty-seven patients with pleural effusion were studied. Diffusion-weighted imaging (DWI) was performed with an echo-planar imaging (EPI) sequence (b values 0, 1000 s/mm2) in 52 patients. The apparent diffusion coefficient (ADC) values were reconstructed from three different regions. Subsequently, thoracentesis was performed and the pleural fluid was analyzed. Laboratory results revealed 20 transudative and 32 exudative effusions. Transudates had a mean ADC value of 3.42±0.76×10–3 mm2/s. Exudates had a mean ADC value of 3.18±1.82×10–3 mm2/s. The optimum cutoff point for ADC values was 3.38×10–3 mm2/s with a sensi-
Introduction Pleural effusions have classically been divided into transudates and exudates. Transudative pleural effusions develop when the systemic factors influencing the formation or absorption of pleural fluid are altered so that pleural fluid accumulates. The fluid may originate in the lungs, the pleura, or the peritoneal cavity [1, 2]. The permeability of the capillaries to proteins is normal in the area where the fluid is formed. In contrast, exudative pleural effusions develop when the pleural surfaces or the capilleries in the location where the fluid originates are altered such that fluid accumulates. The primary reason to differentiate transudates and exudates is that if the
tivity of 90.6% and specificity of 85%. A significant negative correlation was seen between ADC values and pleural fluid protein, albumin concentrations and lactate dehydrogenase (LDH) measurements (r=–0.69, –0.66, and –0.46, respectively; p
