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Chest MRI
Definition
A chest MRI (magnetic resonance imaging) scan is a imaging test that uses powerful magnets and radio waves to create pictures of the chest, or thoracic, area. It does not use radiation (x-rays).
See also: Magnetic resonance imaging (MRI)
Alternative Names
Nuclear magnetic resonance - chest; Magnetic resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI
How the Test is Performed
You may be asked to wear a hospital gown or clothing without metal fasteners (such as sweatpants and a t-shirt). Certain types of metal can cause blurry images or be dangerous to have on in the scanner room.
You will lie on a narrow table, which slides into a large tunnel-shaped scanner.
Some exams require a special dye (contrast). The dye is usually given before the test through a vein (IV) in your hand or forearm. The dye helps the radiologist see certain areas more clearly.
During the MRI, the person who operates the machine will watch you from another room. The test most often lasts 30-60 minutes, but may take longer.
How to Prepare for the Test
You may be asked not to eat or drink anything for 4 - 6 hours before the scan.
Tell your doctor if you are afraid of close spaces (have claustrophobia). You may be given a medicine to help you feel sleepy and less anxious, or your doctor may suggest an "open" MRI, in which the machine is not as close to the body.
Before the test, tell your health care provider if you have:
- Brain aneurysm clips
- Certain types of artificial heart valves
- Heart defibrillator or pacemaker
- Inner ear (cochlear) implants
- Kidney disease or dialysis (you may not be able to receive contrast)
- Recently placed artificial joints
- Certain types of vascular stents
- Worked with sheet metal in the past (you may need tests to check for metal pieces in your eyes)
Because the MRI contains strong magnets, metal objects are not allowed into the room with the MRI scanner:
- Pens, pocketknives, and eyeglasses may fly across the room.
- Items such as jewelry, watches, credit cards, and hearing aids can be damaged.
- Pins, hairpins, metal zippers, and similar metallic items can distort the images.
- Removable dental work should be taken out just before the scan.
How the Test Will Feel
An MRI exam causes no pain. If you have difficulty lying still or are very nervous, you may be given a medicine to relax you. Too much movement can blur MRI images and cause errors.
The table may be hard or cold, but you can request a blanket or pillow. The machine produces loud thumping and humming noises when turned on. You can wear ear plugs to help reduce the noise.
An intercom in the room allows you to speak to someone at any time. Some MRIs have televisions and special headphones that you can use to help the time pass.
There is no recovery time, unless you were given a medicine to relax. After an MRI scan, you can resume your normal diet, activity, and medications.
Why the Test is Performed
A chest MRI provides detailed pictures of tissues within the chest area.
A chest MRI may be done for the following reasons:
- As an alternative to angiography, or to avoid repeated exposure to radiation
- Clarify findings from previous x-rays or CT scans
- Diagnose abnormal growths in the chest
- Evaluate blood flow
- Show lymph nodes and blood vessels
- Show the structures of the chest from multiple angles
- See if cancer in the chest has spread to other areas of the body - this is called staging; staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future
- Tell the difference between tumors and normal tissue
Normal Results
A normal result means your chest area appears normal.
What Abnormal Results Mean
An abnormal chest MRI may be due to:
- Abnormal blood vessels in the lungs (pulmonary vessels)
- Abnormal lymph nodes
- Aortic dissection
- Aortic stenosis
- Atrial myxoma
- Atrial septal defect
- Bronchial abnormalities
- Bronchiectasis
- Cardiac tamponade
- Chronic obstructive pulmonary disease (COPD)
- Coarctation of the aorta
- Constrictive pericarditis
- Cystic lung lesions
- Esophageal tumor
- Ischemic cardiomyopathy
- Lung tumors
- Mitral regurgitation - acute
- Mitral regurgitation - chronic
- Mitral valve prolapse
- Other masses or tumors of the chest
- Pericardial effusion
- Pericarditis
- Pleural abnormalities, including thickening or pleural effusion
- Pulmonary edema
- Restrictive cardiomyopathy
- Superior vena cava (SVC) obstruction
- Thoracic aortic aneurysm
- Thymus tumor
- Tumors of the chest
Consult your health care provider with any questions and concerns.
Risks
MRI uses no radiation. To date, no side effects from the magnetic fields and radio waves have been reported.
The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions to the substance rarely occur. However, gadolinium can be harmful to patients with kidney problems who require dialysis. If you have kidney problems, please tell your health care provider before the test.
The strong magnetic fields created during an MRI can cause heart pacemakers and other implants to not work as well. It can also cause a piece of metal inside your body to move or shift.
Considerations
Currently, MRI is not considered a valuable tool for spotting or monitoring slight changes in lung tissue, since the lungs contain mostly air and are difficult to image.
Disadvantages of MRI include:
- High cost
- Long duration of the scan
- Sensitivity to movement
References
Gotway MB, Elicker BM. Radiographic techniques. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 19.
Stark P. Imaging in pulmonary disease. In: Goldman L,Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 84.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
