Nguyen Elsie T, Bayanati Hamid, Bilawich Ana-Maria, Tijmes Felipe Sanchez, Lim Robert, Harris Scott, Dennie Carole, Oikonomou Anastasia
Cardiothoracic Division, Joint Department of Medical Imaging, 33540Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
Thoracic Division, Department of Medical Imaging, The Ottawa Hospital, 12365University of Ottawa, Ottawa, Ontario, Canada.
Can Assoc Radiol J. 2021 Nov;72(4):831-845. doi: 10.1177/0846537121998961. Epub 2021 Mar 29.
Historically thoracic MRI has been limited by the lower proton density of lung parenchyma, cardiac and respiratory motion artifacts and long acquisition times. Recent technological advancements in MR hardware systems and improvement in MR pulse sequences have helped overcome these limitations and expand clinical opportunities for non-vascular thoracic MRI. Non-vascular thoracic MRI has been established as a problem-solving imaging modality for characterization of thymic, mediastinal, pleural chest wall and superior sulcus tumors and for detection of endometriosis. It is increasingly recognized as a powerful imaging tool for detection and characterization of lung nodules and for assessment of lung cancer staging. The lack of ionizing radiation makes thoracic MRI an invaluable imaging modality for young patients, pregnancy and for frequent serial follow-up imaging. Lack of familiarity and exposure to non-vascular thoracic MRI and lack of consistency in existing MRI protocols have called for clinical practice guidance. The purpose of this guide, which was developed by the Canadian Society of Thoracic Radiology and endorsed by the Canadian Association of Radiologists, is to familiarize radiologists, other interested clinicians and MR technologists with common and less common clinical indications for non-vascular thoracic MRI, discuss the fundamental imaging findings and focus on basic and more advanced MRI sequences tailored to specific clinical questions.
从历史上看，胸部磁共振成像（MRI）一直受到肺实质质子密度较低、心脏和呼吸运动伪影以及采集时间长的限制。磁共振硬件系统的最新技术进步以及磁共振脉冲序列的改进有助于克服这些限制，并扩大非血管性胸部MRI的临床应用机会。非血管性胸部MRI已成为一种解决问题的成像方式，用于胸腺、纵隔、胸膜胸壁和肺尖部肿瘤的特征描述以及子宫内膜异位症的检测。它越来越被认为是一种强大的成像工具，用于肺结节的检测和特征描述以及肺癌分期的评估。无电离辐射使得胸部MRI成为年轻患者、孕妇以及频繁进行系列随访成像时的一种非常有价值的成像方式。对非血管性胸部MRI缺乏熟悉和接触，以及现有MRI协议缺乏一致性，都需要临床实践指导。本指南由加拿大胸放射学会制定并得到加拿大放射学家协会认可，其目的是使放射科医生、其他感兴趣的临床医生和磁共振技术人员熟悉非血管性胸部MRI常见和不常见的临床适应症，讨论基本的影像学表现，并重点关注针对特定临床问题的基础和更先进的MRI序列。
