[Value of magnetic resonance tomography in Pancoast and other tumors with infiltration of the thoracic wall]

Abstract

Twenty-two patients with intrathoracic malignancies and suspected Pancoast and "break-out" tumours were submitted to a comparative investigation using CT scanning and MRI to detect infiltration of the chest-wall. In the patients, the lesion had been confirmed at surgery, which revealed malignant infiltration in 19 cases, and excluded in filtration in 3 cases. In 14 out of 19 patients, the CT scan revealed tumourous involvement of the chest-wall, while in five out of 19 patients, no such involvement was detected. Using MR imaging, tumour infiltration was detected in all 19 patients. A reliable MR sign of tumour involvement was the detection of signal-intensive lesions within the chest-wall in T1-weighted images following the administration of Gd-DTPA, and in the T2-weighted images. In contrast, signal enhancement of the pleura was found both in tumour involvement and in inflammation. In suspected tumorous chest-wall invasion MR imaging can demonstrate tumour involvement of the chest-wall when CT is equivocal.