MR of the mediastinum
Indications for mediastinal MRI:
- Tumors and diseases of the mediastinum, including the esophagus, trachea,
- pericardium,
- aortic arch and mediastinal vessels, swallowing disorders (dysphagia),
- esophageal varices,
- reflux esophagitis,
- esophageal cancer,
- Assessment of lymph nodes, vascular lesions,
- assessment of lung cancer infiltration
The examination also finds its use in the evaluation of thoracic organs (here, in particular, in benign, malignant processes, both primary and metastatic, as well as in chronic or atypical inflammatory conditions).
Other groups of indications for mediastinal MR imaging include:
- Assessing the extent of infiltration in esophageal cancers,
- changes in mediastinal lymph nodes,
- pulmonary embolism,
- radiation lesions, tumor infiltration coming out of the pericardium or heart, and chest trauma.
Magnetic resonance of the respiratory system (MR of the mediastinum) is a very rarely used test. It is not suitable for evaluating the lung parenchyma, due to the large volume of air and the mobility of this organ, a CT scan is more often ordered.
In order to selectively evaluate lung tissue, we perform computed tomography of the chest (HRCT – high resolution computed tomography) is otherwise known as high resolution tomography. It does not require the administration of a contrast agent. HRCT is primarily used to accurately assess lung parenchyma, including sarcoidosis, histiocytosis X, pneumoconiosis, systemic connective tissue diseases, interstitial pulmonary fibrosis, bronchial dilatation and emphysema.
Contraindications to mediastinal magnetic resonance imaging
Absolute contraindications to MRI include any electronic devices implanted in the patient’s body, such as:
- pacemakers, defibrillators or cardiac pacemakers
- insulin pumps
- neurostimulators
- Hearing prostheses, intracochlear implants
- Any ferromagnetic prosthesis (old type), metal bullets after being shot, metal filings (especially in the eye) and other metals placed in the body.
- Dental implants, retainers or even fixed braces are not a contraindication to the test.
- Currently, a large number of implants are not a contraindication to examination in the high electromagnetic field found in MRI, because they are created from alloys of materials that do not show ferromagnetic properties, such as titanium.
- A special contraindication is the patient’s pregnancy, especially the first trimester! Patients during pregnancy are strongly discouraged from having an MRI unless the mother’s life is at risk and the test cannot be postponed.
Course of the mediastinal MR examination
On the day of the examination, you must appear half an hour before your appointment to complete the questionnaire. We ask that each patient bring all medical records pertaining to the area being examined, i.e. previous descriptions and records of imaging studies, hospital discharges, appointment cards, etc.
No special preparation is needed for the examination without the use of a contrast agent.
The mediastinal MRI examination takes about one hour (longer for examinations using contrast). During the examination, you should lie as still as possible and listen to the commands given by the electroradiologist during the test.
The MRI makes loud noises during the test, but the patient is always given earplugs or headphones to muffle the noise.