Basics of thoracic magnetic resonance imaging

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This chapter provides an overview of the basic principles and applications of magnetic resonance imaging (MRI) for thoracic disorders in veterinary medicine. It outlines common indications for thoracic MRI, including further investigation of lesions detected with other imaging modalities and recent advances in cardiac MRI for morphological and functional cardiac assessment. In addition, it explores the relative merits and limitations of MRI compared to computed tomography, notably the superior soft tissue detail but increased acquisition time and motion artefacts. Key thoracic structures and common pathologies that can be assessed with MRI are described, including thoracic wall and pleural space masses, mediastinal lesions, cardiac tumours and rib lesions.

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4.1 (a) Dorsal STIR and (b) transverse T2-weighted images of an adult Domestic Shorthaired cat in ventral recumbency with an injection-site sarcoma in the left interscapular region (arrowed). These images were acquired with a low-field MRI magnet (0.2 Tesla).
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4.2 (a) Transverse T2-weighted and (b) dorsal STIR images of an 8-year-old Maine Coon cat in ventral recumbency with a left thoracic wall mass (arrowed). On the transverse image, severe rib osteolysis is visible.
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4.3 (a) Transverse T1 fat-saturated and (b) T2-weighted images of a 2-year-old adult Borzoi in dorsal recumbency. Pleural effusion is present, with different intensity compared with the chest wall and lungs on both sequences (arrowed).
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4.4 (a) Sagittal and (b) transverse T2-weighted images of a 15-year-old Domestic Shorthaired cat with a mediastinal expansile mass compatible with a diagnosis of thymoma (arrowed).
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4.5 Dorsal cardiac image (black blood study) identifying two hyperintense lesions in the heart wall of a dog (arrowed) – a larger nodule at the apex and a small nodule associated with the interventricular septum. Only the larger lesion was identified on echocardiography. The lesions were presumed to be metastases from a confirmed splenic haemangiosarcoma.
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4.6 Bright blood study of a normal canine heart, single image of a cine loop. Image plane optimized for assessing mitral and aortic valves. (Courtesy of Chris Warren-Smith)
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4.7 Dorsal, fat-saturated T2-weighted cardiac image (black blood study) of a large right atrial and auricular mass in a dog. In this plane, the mass compresses the free wall of the right ventricle (arrowed). Concurrent pericardial effusion surrounds the mass and heart (arrowhead). Complete suppression of blood flow could only be achieved for the most centrally located laminar blood in the ventricles.
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4.8 (a) Ventrodorsal and (b) right lateral thoracic radiographs of a dog. Notice the increased soft tissue opacity of the cranial mediastinum continuous with the cardiac silhouette. The soft tissue has a rounded cranial border and may be contributing to some degree of rightward displacement of the trachea at the level of the heart base. (c) Dorsal and (d) sagittal cardiac MR images (black blood study) show the source of the increased radiographic soft tissue opacity as a focal right auricular dilatation. The pericardium is intact cranially, outlined by hyperintense intrapericardial and mediastinal fat. Suppression of blood flow is nearly complete in all the visible heart chambers.
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