A chest MRI uses powerful magnets and radio waves to construct pictures of the body.

Unlike conventional radiography and computed tomographic (CT) imaging, which make use of potentially harmful radiation (x-rays) that passes through a patient to generate images, magnetic resonance imaging (MRI) is based on the magnetic properties of atoms.

A powerful magnet generates a magnetic field roughly 10,000 times stronger than the Earth's. A very small percentage of hydrogen atoms within the body will align with this field. Radio wave pulses are broadcast towards the aligned hydrogen atoms in tissues of interest, returning a signal of their own. The subtle differing characteristics of that signal from different tissues enables MRI to differentiate between various organs, and potentially, provide contrast between benign and malignant tissue.

Any imaging plane, or "slice", can be projected, and then stored in a computer or printed on film. MRI can easily be performed through clothing and bones, however, certain types of metal in or around the area of interest can cause significant errors in the reconstructed images.

Since MRI makes use of radio waves very close in frequency to those of ordinary FM radio stations, the scanner must be located within a specially shielded room to avoid outside interference. The patient will be asked to lie on a narrow table that slides into a large, tunnel-like tube within the scanner.

If contrast dye is used, it will be injected into a small vein of the hand or forearm. A technologist will operate the machine and observe you during the entire study from an adjacent room.

Several sets of images are usually required, each taking from 2 to 15 minutes. Depending on the sequences performed and the possibility of the need for contrast enhancement, a complete scan may take up to a hour or more. Newer scanners with more powerful magnets, updated software, and advanced sequences may complete the process in less time.

No preparatory tests, diets, or medications are usually needed. An MRI may be performed immediately after other imaging studies.

Because of the strong magnets, certain metallic objects are not allowed into 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 prior to the scan. Pens, pocketknives, and eyeglasses can become dangerous projectiles when magnet is activated and should not accompany the patient into the scanner area.

Because the strong magnetic fields can displace or disrupt the action of implanted metallic objects, people with cardiac pacemakers cannot be scanned and should not enter the MRI area. MRI also should not be used for people with metallic objects in their bodies such as inner ear (cochlear) implants, brain aneurysm clips, some artificial heart valves, older vascular stents, and recently placed artificial joints.

Sheet metal workers, or persons with similar potential exposure to small metal fragments, will first be screened for metal shards within the eyes with x-rays of the skull. The patient will be asked to sign a consent form confirming that none of the above issues apply before the study will be performed.

A hospital gown may be recommended, or the patient may be allowed to wear a sweatsuit or similar clothing without metal fasteners.

There is no pain. The magnetic field and radio waves are not felt. Some people experience a claustrophobic feeling from being inside the scanner. The table may be hard or cold, but you can request a blanket or pillow.

The machine produces loud thumping and humming noises during normal operation. Ear plugs are usually given to the patient to reduce the noise. A technologist observes the patient during the entire procedure and may be spoken to through an intercom in the scanner. Some MRI scanners are equipped with televisions and special headphones to help the examination time pass.

Excessive movement can blur MRI images and cause errors in the image. If the patient has difficulty lying still or is very anxious, an oral or intravenous sedative may be given. There is no recovery, unless sedation was necessary. After an MRI scan, you can resume normal diet, activity, and medications.

An MRI provides detailed pictures of tissues within the chest cavity, without obstruction by overlying bone. It may be used to:

• Clarify findings from previous x-rays or CT scans.
• Show the structures of the chest from multiple planes.
• Help diagnose abnormal growths and provide information for the staging (such as the size, extent, and spread) of tumors in the chest cavity. MRI can distinguish tumors or other lesions from normal tissues.
• Show lymph nodes and blood vessels.
• Evaluate blood flow.
• Avoid the dangers of angiography, or of repeated exposure to radiation.