General Requirements of MRi of the Lung and suggested standard Protocol

MRI of the lung has been shown to be highly sensitive to infiltrative and solid pathology. It offers particular advantages beyond the scope of CT such as dynamic studies of respiratory mechanics and first pass perfusion imaging. However, challenges such as motion artifacts and low signal have delayed the introduction into clinical routine. This chapter discusses the strategies to overcome these obstacles and suggests a comprehensive protocol for a spectrum of indications. This comprises a basic selection of non-contrast enhanced sequences and can be extended by contrast enhanced series. Breath hold T1and T2-weighted imaging are applied for the detection of small solid lesions and infiltrates. Inversion recovery series visualize enlarged lymph nodes and skeletal lesions. Steady-state gradient echo series in free breathing contribute to the detection of pulmonary embolism, cardiac dysfunction and impairment of respiratory mechanics. Tumors, suspicious pleural effusions and inflammatory diseases warrant additional contrast-enhanced sequences. Perfusion studies contribute to imaging of thromboembolic vascular and obstructive airway diseases.