Lung examination CT or MRI

Question

Dear expert team,

With which examination method a radiologist or lung specialist is able to identify the following findings/diagnoses:

• lung emphysema
• obstructive bronchitis (COPD)
• bronchiectasis
• pulmonary embolism

What would be advisable to do with regards to the diseases mentioned above in order to make a more precise diagnosis (X-ray, CT or MRI).

Thank you for answering quickly.

Answer

Hello,

Making a diagnosis is not so easy that one can reduce it to the question if it is better to have a CT or MRI done. Depending on the question or presumption diagnosis one or the other technique can be more suitable, sometimes we also need an additional second imaging.

What can be the most suitable method in the individual case has to be decided by a lung specialist (if necessary together with an X-ray specialist) who knows all details, which means all of the symptoms and complaints of the patient and all other clincal and laboratory findings .

Generally speaking it can be said that a CT is best for the lung emphysema; the obstructive bronchitis can, in fact, not be represented by an image (gold-standard is the lung function) whereas bronchiectasis can be evaluated best by a CT. As a standard procedure a pulmonary embolism is diagnosed by a special CT checkup that exists for this kind of question (the contrast media is given differently with regards to other clinical entities). A pulmonary embolism can frequently also be seen well in a MRI.

Best regards,
Prof. Dr. TOF Wagner

08.07.2008