Magnetic resonance (MR) imaging of the chest: state-of-the-art

Abstract

To date, magnetic resonance (MR) is established as an imaging modality in the diagnosis of chest diseases. Because of its excellent distinction of vessels and soft tissue, MR can be performed as the primary imaging procedure before computed tomography in patients with suspected vascular lesions, mediastinal masses, hilar lesions, and pathological changes of the pleura and the chest wall. In these cases, MR is able to provide all the necessary diagnostic information. In other patients, a limited number of MR images may be helpful in cases of equivocal or confusing CT or clinical findings. More detailed information can be obtained, using surface coils or special imaging sequences, i.e. high resolution MR images of the pleura or angiographic images of mediastinal and pulmonary vasculature. From a clinical viewpoint, the most important task for thoracic magnetic resonance nowadays is the pretherapeutic evaluation of intrathoracic masses, the differential diagnosis of benign versus malignant lesions, and the accurate documentation of tumour extent in malignancies including three-dimensional-display to improve surgical or radiation planning. Future directions in thoracic magnetic resonance will be predominantly influenced by postprocessing approaches, specialized imaging techniques, and magnetic resonance-guided interventional applications.

MRI of pneumonia in immunocompromised patients: comparison with CT

“…Current navigation techniques, which compensate for moving artifacts, and the development of sequences aimed at minimizing the negative effects of respiratory movements by providing the acquisition of rapid images have significantly increased image quality in pulmonary evaluation and relatively shortened the test duration. Thus, MRI evaluation of the pulmonary parenchyma has reached a level comparable to that of CT (10). Among patients who have hematologic malignancies and have undergone chemotherapy, fungal and bacterial infection of the lung is a frequent serious pulmonary complication in those who are immunocompromised.…”

The role of positron emission tomography with18F-fluoro-2-deoxy-D-glucose in respiratory oncology

“…in situations where superior sulcus extension or relationship with the heart or large vessels is of importance [58]. With their exquisite anatomical detail, modern CT and MRI are the preferred tests to evaluate the T-factor.…”

Management of malignant pleural effusions

“…Ultrasonography may aid in identifying pleural lesions in patients with malignant effusions and can be helpful in directing thoracentesis in patients with small effusions and avoiding thoracentesis complications [27]. The role of magnetic resonance imaging (MRI) in malignant effusions appears limited, but MRI may be helpful in evaluating the extent of chest wall involvement by tumour [28][29][30]. There is little information available on the utilization of fluorodeoxyglucose positron emission tomography (PET) in malignant pleural effusions, although it has been reported as helpful in evaluating the extent of disease in malignant mesothelioma [31].…”