Fast T1- and T2-weighted pulmonary MR-imaging in patients with bronchial carcinoma

Both, M.; Schultze, J.; Reuter, M.; Bewig, B.; Hubner, R.; Bobis, I.; Noth, R.; Heller, M.; Biederer, J.

doi:10.1016/j.ejrad.2004.05.007

« Previous Next »European Journal of Radiology
Volume 53, Issue 3 , Pages 478-488, March 2005

Fast T1- and T2-weighted pulmonary MR-imaging in patients with bronchial carcinoma

M. Both
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany
- Corresponding author. Tel.: +49 43 1597 3153; fax: +49 43 1597 3151.
J. Schultze
- Department of Radiation Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
M. Reuter
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany
B. Bewig
- Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
R. Hubner
- Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
I. Bobis
- Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
R. Noth
- Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
M. Heller
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany
J. Biederer
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany

Abstract

Purpose:

A prospective study to evaluate the diagnostic potential and limitations of three fast MRI sequences in patients with bronchial carcinoma based on the comparison with spiral CT.

Material and methods:

Three fast chest MRI sequences from 20 patients with central or peripheral bronchial carcinoma were evaluated by two observers for relation of tumour to adjacent structures, lymph node enlargement, additional pulmonary lesions and artefacts. The information from MR-imaging was compared with the results from spiral CT. MRI comprised a T1-3D-GRE breath-hold examination (“VIBE”, TR/TE 4.5/1.9ms, flip-angle 12°, matrix 502 × 512, 2.5mm coronal slices), a breath-hold, T2-HASTE sequence (TR/TE 2000/43ms, matrix 192 × 256, 10mm coronal slices) and a respiration-triggered T2-TSE sequence (TR/TE 3000–6000/120ms, matrix 270 × 512, 6mm transverse slices). The FOV was adapted individually (380–480mm).

Results:

The presence of the primary bronchial carcinoma and infiltration of thoracic structures by tumour tissue could be demonstrated by all sequences. VIBE sequence was more suitable for detecting small pulmonary nodules than the other MRI examinations, but compared to CT still 20% of these lesions were missed. Contrary to VIBE and T2-weighted TSE scans, HASTE sequence was limited in imaging mediastinal lymph nodes due to missing relevant findings in 2/20 patients. HASTE images significantly provided the lowest rate of artefacts in imaging lung parenchyma (P < 0.001 in peripheral parenchyma), but spatial resolution was limited in this sequence. Concerning the differentiation between tumour and adjacent atelectasis (n = 8), T2-weighted TSE imaging was superior to CT and VIBE in all cases and to HASTE sequence in 4/8 patients.

Conclusion:

The combination of VIBE and HASTE sequence allows for an adaequate imaging of thoracic processes in patients with bronchial carcinoma, limited only in visualizing small pulmonary nodules. To obtain more detail resolution and to differentiate tumour tissue from adjacent atelectasis, T2-TSE examination may be added in selected cases.

Keywords: Bronchial carcinoma, Lung, MRI, CT