In general, MRI is only considered as a second-line imaging tool for the evaluation
of lung disease. Among the major disadvantages to CT are the inferior spatial resolution
and longer imaging times. Recent technical developments, such as high performance
gradient systems, optimised pulse sequences, and parallel imaging techniques have
substantially improved the potential of MRI for the assessment of lung disease.
The morphology of the pulmonary circulation can be assessed by non-enhanced and contrast-enhanced
MR angiography. Contrast-enhanced MR angiography may be performed with high spatial
and temporal resolution. The latter can be used for a functional assessment of pulmonary
blood flow and parenchymal perfusion. Additional functional studies of the pulmonary
circulation include phase-contrast MRI and CINE MRI of the right heart. MRI has the
unique advantage to combine the assessment of morphology and function in a comprehensive
imaging protocol.
MRI of the pulmonary circulation has been evaluated in a variety of lung diseases.
One example is pulmonary embolism. Due to the unspecific clinical presentation a high
number of patients with suspected pulmonary embolism is finally diagnosed as having
no pulmonary embolism. Depending on the clinical probability MRI may be considered
as a radiation-free alternative imaging method to rule out pulmonary embolism in patients
with low clinical probability for pulmonary embolism. Another potential indication
for MRI in pulmonary embolism may be the follow-up of thrombus resolution during anticoagulative
therapy. Other pulmonary vascular diseases in which MRI can be effectively used include
pulmonary arterial hypertension, arteriovenous-malformation, and congenital heart
disease. Also in airway disease and lung cancer MRI of the pulmonary circulation may
contribute additional diagnostic information.
Lernziele:
The learning objectives of this contribution are: 1. To review MR imaging techniques
for the diagnostic evaluation of the pulmonary circulation. 2. To illustrate clinical
indications for the use of MRI in the assessment of pulmonary vascular disease.
Korrespondierender Autor: Fink C
Klinikum Grosshadern, Institut für klinische Radiologie, Marchioninistr. 15, 81377
München
E-Mail: christian.fink@med.uni-muenchen.de
