[Chest wall and mediastinum invasion by lung cancer--a CT and MRI evaluation]

CT and MRI manifestations of 52 peripheral lung cancers located close to the pleural surface or mediastinal structures were studied correlating with the surgical and pathologic findings. Rib destruction as shown by CT and T2 weighted MRI showing the encroachment of tumor upon the chest wall were crucial in demonstrating chest wall invasion. An obtuse chest wall intersecting angle and the length of the neighboring borders of the tumor and chest wall were of limited value. Local pleural thickening was observed near the tumor in 54% of cases, over half of them showed obtuse angle between the tumor and the chest wall but without tumor invasion. T2 weighted MRI was more reliable than CT by showing different signal intensities for pleural thickening, inflammation, localized pleural effusion or tumor invasion to chest wall soft tissue.