Mediastinal and Pleural MR Imaging: Practical Approach for Daily Practice

Area of Science:

• Radiology
• Medical Imaging
• Thoracic Imaging

Background:

• Thoracic magnetic resonance (MR) imaging is increasingly used for noncardiac and nonangiographic applications.
• Effective thoracic MR imaging protocols require understanding sequence building blocks, often adapted from other body regions.
• Modifications like electrocardiographic gating or respiratory triggering may be needed for specific thoracic applications.

Purpose of the Study:

• To highlight the clinical utility of thoracic MR imaging beyond conventional modalities.
• To guide radiologists in recognizing scenarios where thoracic MR imaging provides significant diagnostic value.
• To emphasize the role of thoracic MR imaging in lesion characterization, surgical planning, and treatment monitoring.

Main Methods:

• Review and adaptation of established MR imaging sequences for thoracic applications.
• Application of specific MR imaging techniques such as cine sequences and diffusion restriction assessment.
• Utilizing MR imaging's contrast resolution and subtraction capabilities for detailed analysis.

Main Results:

• Thoracic MR imaging excels in evaluating indeterminate lesions, confirming fluid presence, and detecting intravoxel lipid.
• It is effective in assessing post-treatment sites for tumor recurrence against background changes.
• MR imaging aids in surgical and treatment planning by identifying biopsy sites and evaluating local tumor invasion.
• It is the preferred modality for imaging potential tumor thrombus.

Conclusions:

• Thoracic MR imaging provides crucial noncardiac and nonangiographic diagnostic information.
• Understanding specific clinical scenarios enhances the value of thoracic MR imaging in patient management.
• Radiologists can improve decision-making by integrating thoracic MR imaging into their practice for diverse thoracic conditions.