Comparison of magnetic resonance imaging and CT scan in patients with complaints of mediastinal and chest wall mass

Abstract

Background: The realm of diagnosing intrathoracic lesions involves a spectrum of imaging methodologies, among which computed tomography (CT)-scan and magnetic resonance imaging (MRI) stand prominent. In the context of Iran, where there is no study comparing the efficacy of CT-scan and MRI for evaluating intrathoracic lesions, our study endeavors to bridge this gap. Mindful of the nuanced advantages and drawbacks inherent in each method, we aim to conduct a comprehensive comparative analysis of CT-scan and MRI in diagnosing intrathoracic lesions, focusing on patients seeking care at Firoozgar Hospital's pulmonary clinic. Methods: Embarking on a cross-sectional exploration at Firoozgar Hospital Pulmonary Clinic in Tehran, Iran, our investigative journey unfolded between April 2020 and March 2021. Thirty patients, spanning ages 21 to 69, presenting with intra-thoracic lesions encompassing mediastinal and chest wall anomalies, underwent simultaneous CT scan and MRI examinations. In pursuit of diagnostic certainty, histopathology was ordained as the gold standard, and the ensuing results underwent meticulous scrutiny and analysis utilizing SPSS 23 statistical software. Results: Our study cohort comprised 30 patients, averaging 44.83 years (SD=12.71), with males constituting 60% of the population. Delving into the histological reports, CT-scan and MRI accurately diagnosed 25 (83.3%) and 28 (93.3%) cases, respectively, in retrospective analysis. The Kappa matching coefficient for CT-scan stood at 0.783, while for MRI, it soared to 0.912. A notable revelation surfaced as the Kappa matching coefficient for both CT-scan and MRI maintained a robust 0.783 (P<0.001 in all three cases). Conclusion: MRI might wield a superior diagnostic prowess compared to CT-scan in evaluating intrathoracic lesions. The robust Kappa matching coefficients endorse a substantial concordance between the two imaging modalities. The implications further beckon contemplation that, in select scenarios, the acquisition of biopsy and histopathology may prove redundant when scrutinizing intrathoracic lesions using the tandem approach of CT-scan and MRI. However, to etch these findings into the annals of medical certainty, a multicenter study endowed with a judicious sample size emerges as an imperative next step.

Keywords

• mediastinal mass
• chest wall mass
• magnetic resonance imaging
• chest computed tomography scan.