Abstract

Despite advances in imaging unit technology and research in the field, the utilization of thoracic MRI in regular clinical practice for noncardiac and nonangiographic applications has lagged behind expectations. To improve utilization, it is incumbent on radiologists to recognize situations in which thoracic MRI may have clinical benefit and recommend its use in radiology reports and multidisciplinary conferences. While there are several clinical scenarios in which nonvascular thoracic MRI has a potential primary role, it is at present most frequently utilized as a problem solving modality to answer specific questions that cannot be determined via other imaging modalities, most commonly CT. The purpose of this talk is to explore commonly encountered situations in which thoracic MRI can be utilized to its fullest extent as a problem solving modality. The most common of these indications is in identifying benign imaging features of mediastinal lesions including intravoxel lipid in suspected benign thymic tissue or the absence of concerning enhancement in cystic mediastinal lesions. MRI is also particularly well suited to evaluate for invasion of local structures, including the mediastinum, chest wall, vessels, and the diaphragm. Finally, MRI can be used to identify biopsy targets in both undiagnosed lesions and in lesions which have previously been treated. In reviewing these scenarios, basic protocol elements and potential pitfalls will be discussed. Ultimately, interpreting these examinations should be achievable for radiologists in any practice, as it relies on frequently used knowledge regarding thoracic anatomy and pathology combined with an understanding of MR imaging principles that are already used elsewhere in the body.

Acknowledgements

No acknowledgement found.

References

Raptis CA, McWilliams SR, Ratkowski KL, et al. Mediastinal and Pleural MR Imaging: Practical Approach for Daily Practice. Radiographics 2018; 38:37-55.