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European Radiology
Published in: European Radiology 4/2018

01-04-2018 | Chest

Nonsuppressing normal thymus on chemical-shift MR imaging and anterior mediastinal lymphoma: differentiation with diffusion-weighted MR imaging by using the apparent diffusion coefficient

Authors: Adriano Massimiliano Priola, Sandro Massimo Priola, Dario Gned, Maria Teresa Giraudo, Andrea Veltri

Published in: European Radiology | Issue 4/2018

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Abstract

Objectives

To prospectively evaluate usefulness of the apparent diffusion coefficient (ADC) in differentiating anterior mediastinal lymphoma from nonsuppressing normal thymus on chemical-shift MR, and to look at the relationship between patient age and ADC.

Methods

Seventy-three young subjects (25 men, 48 women; age range, 9-29 years), who underwent chemical-shift MR and diffusion-weighted MR were divided into a normal thymus group (group A, 40 subjects), and a lymphoma group (group B, 33 patients). For group A, all subjects had normal thymus with no suppression on opposed-phase chemical-shift MR. Two readers measured the signal intensity index (SII) and ADC. Differences in SII and ADC between groups were tested using t-test. ADC was correlated with age using Pearson correlation coefficient.

Results

Mean SII±standard deviation was 2.7±1.8% for group A and 2.2±2.4% for group B, with no significant difference between groups (P=.270). Mean ADC was 2.48±0.38x10-3mm2/s for group A and 1.24±0.23x10-3mm2/s for group B. A significant difference between groups was found (P<.001), with no overlap in range. Lastly, significant correlation was found between age and ADC (r=0.935, P<.001) in group A.

Conclusions

ADC of diffusion-weighted MR is a noninvasive and accurate parameter for differentiating lymphoma from nonsuppressing thymus on chemical-shift MR in young subjects.

Key Points

• SII cannot differentiate mediastinal lymphoma from nonsuppressing normal thymus at visual assessment
• ADC is useful for distinguishing nonsuppressing normal thymus from mediastinal lymphoma
• ADC is more accurate than transverse-diameter and surface-area in this discrimination
• ADC of normal thymus is age dependent and increases with increasing age
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Metadata
Title
Nonsuppressing normal thymus on chemical-shift MR imaging and anterior mediastinal lymphoma: differentiation with diffusion-weighted MR imaging by using the apparent diffusion coefficient
Authors
Adriano Massimiliano Priola
Sandro Massimo Priola
Dario Gned
Maria Teresa Giraudo
Andrea Veltri
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5142-z

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