MRI of the thorax

We carried out a retrospective analysis of about 100 surgical cases of mediastinal, pleural, chest wall and pulmonary disorders in order to determine the clinical application and efficacy of magnetic resonance imaging (MRI) of the thorax. Coronal and/or axial image of T1-weighted images were obtained in all cases, and T2-weighted or gadolinium-DTPA contrast-enhanced T1-weighted images were additionally obtained in several selected cases. All MR images were compared with findings of chest X-ray, CT and intravenous digital subtraction angiography (IVDSA) as appropriate. As a result, MR images were considered to provide additional information to that obtained by conventional techniques of chest X-ray and CT, in demonstrating chest wall invasion of pulmonary carcinoma, detecting hilar masses, which were difficult to distinguish from vessels, and in defining mediastinal masses. The anterior segment of the diaphragms is clearly depicted, aiding the differentiation of Morgagni hernia from other entities. Tuberculoma showed peripheral enhancement in Gd-enhanced T1WI, which was distinctly different from the enhancing pattern of carcinomas. With the use of surface coil, the pleura and chest wall anatomy were clearly demonstrated. It is hoped that the wide application of this technique will increase the diagnostic accuracy of chest wall tumor invasion. (author)