Ressonância magnética do tórax: aplicações tradicionais e novas, com ênfase em pneumologia

Abstract

The objective of the present review study was to present the principal applications of magnetic resonance imaging (MRI) of the chest, including the description of new techniques. Over the past decade, this method has evolved considerably because of the development of new equipment, including the simultaneous interconnection of phased-array multiple radiofrequency receiver coils and remote control of the table movement, in addition to faster techniques of image acquisition, such as parallel imaging and partial Fourier acquisitions, as well as the introduction of new contrast agents. All of these advances have allowed MRI to gain ground in the study of various pathologies of the chest, including lung diseases. Currently, MRI is considered the modality of choice for the evaluation of lesions in the mediastinum and in the chest wall, as well as of superior sulcus tumors. However, it can also facilitate the diagnosis of lung, pleural, and cardiac diseases, as well as of those related to the pulmonary vasculature. Pulmonary MRI angiography can be used in order to evaluate various pulmonary vascular diseases, and it has played an ever greater role in the study of thromboembolism. Because cardiac MRI allows morphological and functional assessment in the same test, it has also become part of the clinical routine in the evaluation of various cardiac diseases. Finally, the role of MRI has been extended to the identification and characterization of pulmonary nodules, the evaluation of airway diseases, and the characterization of pleural effusion.

Endometriose pleural: achados na ressonância magnética

“…Because of improvements in speed and image quality, MRI is now ready for routine clinical use. (7)(8)(9) In both of the cases presented here, chest MRI revealed hydropneumothorax and well-defined, rounded nodules on the pleural surface in the right hemithorax. In Case 1, the pleural effusion had intermediate signal intensity on T1-weighted images, suggesting high protein content, probably related to hemorrhagic products.…”

Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

“…Such techniques are very fast and allow for images acquisition in 50 ms, literally promoting a "freezing" of the physiological movement, being widely utilized in the acquisition of diffusion-weighted sequences. These technical steps are aimed at avoiding the occurrence of motion artifacts that affect the quality of the images ( 6 , 9 , 10 , 35 ) .…”

“…The T2-weighted sequences should be routinely performed with and without fat suppression ( 10 ) . The joint analysis of these sequences allows for a greater contrast between normal anatomical structures and areas affected by the tumor, increasing the method reliability ( 9 , 10 , 35 ) . The introduction of new morphological and functional techniques has also significantly contributed to an appropriate management of cancer patients.…”

“…A range of tumor lesions may affect the chest, from tumors of epithelial origin such as breast, lung, tracheal, esophageal, thymic carcinomas, and embryonic germ cell carcinomas to tumors of mesenchymal origin, including liposarcomas, osteosarcomas, leiomyosarcomas and lymphomas ( 15 , 35 , 36 , 40 , 41 , 43 , 48 , 49 ) . The chest is also a frequent site of metastatic implants from originally primary tumors or from extrathoracic tumors, either by lymphatic or hematogenous dissemination or by contiguity ( 40 - 42 ) .…”

Chest magnetic resonance imaging: a protocol suggestion

“…Recently, further improvements in MRI techniques have widened the potential for investigation of pulmonary parenchymal diseases. Such techniques include very short echo times, ultrafast turbo-spin-echo acquisitions, projection reconstruction technique, breathhold imaging, and recently developed contrast agents (for perfusion and ventilation imaging) ( 1 - 3 ) .…”