Name of the Procedure:

Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences.

Summary

Magnetic Resonance Imaging (MRI) of the chest is a non-invasive procedure that uses powerful magnets and radio waves to create detailed images of the chest, including the lungs, heart, and surrounding lymph nodes. This specific version of the MRI first scans the area without using a contrast material, then introduces a contrast material to provide clearer images, followed by additional scanning sequences.

Purpose

MRI of the chest is used to diagnose or evaluate conditions affecting the chest cavity, such as lymphadenopathy (swollen lymph nodes), tumors, and abnormalities in the mediastinal and hilar regions. It aims to provide a detailed view of these areas to aid in diagnosis and guide treatment planning.

Indications

• Persistent cough or chest pain
• Unexplained weight loss
• Suspicion of mediastinal or hilar lymphadenopathy
• Abnormalities detected on previous imaging tests (e.g., X-ray, CT scan)
• Preoperative evaluation or staging of certain cancers

Preparation

• Patients may need to fast for a few hours before the procedure.
• They should inform the medical team of any allergies, particularly to contrast materials.
• All metallic objects must be removed due to the MRI's powerful magnets.
• Pre-procedure diagnostic tests, such as blood tests, might be required to ensure kidney function is adequate for contrast materials.

Procedure Description

1. The patient lies on the MRI table, which slides into the MRI machine.
2. Initial images are taken without contrast material to establish a baseline.
3. Contrast material is then administered intravenously to enhance image quality.
4. Additional MRI sequences are performed to capture detailed images of the chest with the contrast.
5. The entire procedure is monitored by a radiologist and a technician who may communicate with the patient through an intercom.

Duration

The procedure usually takes between 45 minutes to an hour.

Setting

Performed in the radiology or imaging department of a hospital or in an outpatient imaging center.

Personnel

• Radiologist
• Radiology technician
• Nursing staff for IV administration

Risks and Complications

• Allergic reaction to the contrast material (although rare)
• Potential discomfort from lying still for a prolonged period
• Rare risk of nephrogenic systemic fibrosis in patients with severe kidney problems

Benefits

• Provides highly detailed images for accurate diagnosis
• Non-invasive with no exposure to ionizing radiation
• Helps in planning effective treatment strategies

Recovery

• Patients can usually resume normal activities immediately.
• It's advised to drink plenty of fluids to help flush out the contrast material.
• Follow-up appointments with the referring physician to discuss the MRI results.

Alternatives

• Chest X-ray: Less detailed, uses ionizing radiation
• CT scan: More detailed than an X-ray but involves ionizing radiation
• PET scan: Used for specific indications like detecting cancer spread but involves radioactive material

Patient Experience

• Patients might hear loud noises from the MRI machine but are usually given earplugs or headphones to reduce discomfort.
• Some patients may experience a warm sensation when the contrast material is injected.
• Pain management is minimal as the procedure is non-invasive. Comfort measures, such as blankets, can be provided for use during the scan.