Magnetresonanztomographie

More than any other lung imaging modality, magnetic resonance imaging (MRI) comprises morphologic and functional imaging aspects in a single examination. In practice, its application is facilitated by dedicated protocols for typical clinical questions and easy handling (e.g. no ECG trigger). The sensitivity of the basic protocol for infiltrates and lung nodules is almost equal to CT. Excellent soft tissue contrast facilitates tumour staging, e.g. the differentiation of tumour and atelectasis and the diagnosis of mediastinal and chest wall masses. Administration of contrast material contributes to detection of tumour necrosis and pleural reaction/carcinosis. Dynamic contrast-enhanced MRI and visualization of respiratory motion contribute functional information. For the diagnosis of pulmonary embolism, an initial, free breathing and non-contrast-enhanced examination for quick detection in case of severe embolism is combined with dynamic contrast-enhanced perfusion imaging, a high-resolution angiogram and a final 3D breath-hold acquisition. With these customized protocols, lung MRI offers not only solutions for tricky problems of daily routine, in particular for imaging the mediastinum. It is as well a good option for paediatrics and science or any situation where any radiation exposure or administration of CT contrast material would be contraindicated.