[Malignant pulmonary neoplasms: diagnostic possibilities of magnetic resonance angiography]

The authors investigated the potentials of Magnetic Resonance Angiography (MRA) in the preoperative staging of malignant central lung neoplasms. Fifteen patients with malignant central lung neoplasms were submitted to MRA 48 hours before surgery, which was the gold standard. The patients were 7 women and 8 men; their mean age was 54.3 years (range: 39-65 years). MRA was performed with the 2D and 3D time-of-flight (TOF) technique. FLASH 2D sequences (FA 18 degrees, TR 40 ms, TE 10 ms, SL 4 mm) and FISP 3D sequences (FA 20 degrees, TR 30 ms, TE 3 ms, SL 1 mm) were used. The images were processed with the maximum intensity projection (MIP) and rotated on different planes with a 15 degrees step. A multiple choice card, implying preoperative reading by an MRA expert, was used; in the study of the relationship between neoplasms and contiguous vessels, only two diagnoses were possible--i.e., infiltrated, not infiltrated. This card included, in the preliminary phase, a code for each MRA pattern--i.e., the presence of a clear cleavage plane, vascular occlusion, stenosis, irregular vessel profile, turbulence and several of these patterns together. MRA was in agreement with surgery in 14/16 cases and overestimated two cases as infiltration. In our preliminary study, MRA had 100% sensitivity, 75% specificity and 87.5% diagnostic accuracy. To conclude, MRA proved to be a complementary tool to spin-echo MR sequences in the staging of malignant central lung neoplasms.