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MR Imaging of the Chest Using a Contrast-Enhanced Breath-Hold Modified Three-Dimensional Gradient-Echo Technique: Comparison with Two-Dimensional Gradient-Echo Technique and Multidetector CT

¹ All authors: Department of Radiology, West Virginia University, School of Medicine, Robert C. Byrd Health Sciences Center, P. O. Box 9235, Morgantown, WV 26505-9235.

View larger version (104K): [in a new window]   Fig. 1A. —46-year-old man referred for evaluation of thoracic aorta. Axial multidetector CT scan obtained at level of bronchus intermedius shows pulmonary nodule (arrow) in left lower lobe adjacent to major fissure and smaller nodule in right upper lobe medial to vessel. Tiny nodular opacity in right lower lobe represents vessel on sequential images.

View larger version (112K): [in a new window]   Fig. 1B. —46-year-old man referred for evaluation of thoracic aorta. Axial fat-suppressed gadolinium-enhanced T1-weighted two-dimensional gradient-echo MR image (TR/TE, 149/5.2; flip angle, 70°) has considerable phase artifacts (arrows) and does not show nodules.

View larger version (112K): [in a new window]   Fig. 1C. —46-year-old man referred for evaluation of thoracic aorta. Axial fat-suppressed gadolinium-enhanced T1-weighted three-dimensional volumetric interpolated breath-hold MR image (3.7/1.7; flip angle, 15°) shows pulmonary nodule (arrow) adjacent to fissure but no nodule in right upper lobe. Note lack of phase artifacts and improved depiction of mediastinal and pulmonary vessels and airways.

View larger version (100K): [in a new window]   Fig. 2A. —59-year-old man with squamous cell carcinoma of lung. Axial multidetector CT scan obtained at level of carina shows central lung mass (arrow) extending into mediastinum and small subsegmental atelectasis in right upper lobe of anterior segment.

View larger version (116K): [in a new window]   Fig. 2B. —59-year-old man with squamous cell carcinoma of lung. Mass (large arrow) is poorly delineated on axial fat-suppressed gadolinium-enhanced T1-weighted two-dimensional gradient-echo MR image (TR/TE, 149/5.2; flip angle, 70°) because of phase artifacts (small arrows).

View larger version (119K): [in a new window]   Fig. 2C. —59-year-old man with squamous cell carcinoma of lung. Axial fat-suppressed gadolinium-enhanced T1-weighted three-dimensional volumetric interpolated breath-hold MR image (3.7/1.7; flip angle, 15°) clearly shows right hilar mass (arrow) and outlines its margins from vessels and right upper lobe bronchus. Note subsegmental atelectasis in right upper lobe anteriorly and lack of phase artifacts that brings about improved image quality.

View larger version (108K): [in a new window]   Fig. 3A. —39-year-old man with chronic cough. Axial fat-suppressed gadolinium-enhanced T1-weighted two-dimensional gradient-echo MR image (TR/TE, 149/5.2; flip angle, 70°) shows suspicious signal change mimicking possible cavitary lesion (arrow) in superior segment of right lower lobe. Note moderate phase artifacts across mediastinum and subcarinal lymphadenopathy (star).

View larger version (101K): [in a new window]   Fig. 3B. —39-year-old man with chronic cough. Axial fat-suppressed gadolinium-enhanced T1-weighted three-dimensional volumetric interpolated breath-hold MR image (B) (3.7/1.7; flip angle, 15°) and axial multidetector CT scan (C) obtained at same level show no corresponding lung lesion. Note subcarinal lymphadenopathy (star) and diminished phase artifacts.

View larger version (111K): [in a new window]   Fig. 3C. —39-year-old man with chronic cough. Axial fat-suppressed gadolinium-enhanced T1-weighted three-dimensional volumetric interpolated breath-hold MR image (B) (3.7/1.7; flip angle, 15°) and axial multidetector CT scan (C) obtained at same level show no corresponding lung lesion. Note subcarinal lymphadenopathy (star) and diminished phase artifacts.

View larger version (97K): [in a new window]   Fig. 4A. —69-year-old woman with squamous cell lung carcinoma. Axial multidetector CT (MDCT) scan obtained at level of ventricles shows peripheral mass (arrow) in right middle lobe. Note dependent opacity posteriorly in lower lobes and prominent pulmonary artery mimicking nodule at right posterior base.

View larger version (99K): [in a new window]   Fig. 4B. —69-year-old woman with squamous cell lung carcinoma. Axial fat-suppressed gadolinium-enhanced T1-weighted two-dimensional gradient-echo MR image (TR/TE, 149/5.2; flip angle, 70°) shows suspicious signal change (large arrow) in corresponding location, but reviewers did not report it as definite mass confidently. Note minimal phase artifacts (small arrows) posterior to heart.

View larger version (103K): [in a new window]   Fig. 4C. —69-year-old woman with squamous cell lung carcinoma. Axial fat-suppressed gadolinium-enhanced T1-weighted three-dimensional volumetric interpolated breath-hold MR image (3.7/1.7; flip angle, 15°) clearly portrays enhancing lung mass (arrow) with central necrosis. Marginal conspicuity of lesion is better delineated. Also note dependent atelectasis posteriorly in lower lobes corresponding to MDCT findings.

View larger version (103K): [in a new window]   Fig. 5A. —69-year-old man with history of cough and fever. Axial multidtector CT scan reveals pulmonary nodule (arrow) in posterior segment of right upper lobe.

View larger version (104K): [in a new window]   Fig. 5B. —69-year-old man with history of cough and fever. Axial fat-suppressed gadolinium-enhanced T1-weighted two-dimensional gradient-echo MR image (TR/TE, 149/5.2; flip angle, 70°) shows mild phase artifacts (arrow) and does not reveal nodule. Note poor visualization of mediastinum and trachea (T).

View larger version (110K): [in a new window]   Fig. 5C. —69-year-old man with history of cough and fever. Axial fat-suppressed gadolinium-enhanced T1-weighted three-dimensional volumetric interpolated breath-hold MR image (3.7/1.7; flip angle, 15°) provides improved depiction of mediastinum and trachea (T) with small pretracheal lymph node. Initially missed pulmonary nodule (arrow) is clearly evident in retrospect.

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