MRI Sternum is an advanced imaging technique of the chest to determine the structure of the breastbone and soft tissue of the chest. The sternum is a flat bone that is positioned in the mid-upper part of the chest, which forms the anterior part of the rib cage and covers some of the vital body organs, including the heart, lungs, and great vessels.

MRI is a safe and normal procedure as it provides deep grading and also has detailed images that are not irradiated. It can predominantly be used in the identification of bone marrow abnormalities, soft tissue trauma, infection, and tumors of the sternum.

Purpose of MRI Sternum

This test can be used to:

• Diagnose bone marrow or post-traumatic fractures.
• Determine infections like osteomyelitis.
• Evaluate tumors or metastases in the sternum.
• Assess the post-operative complications (i.e., after the sternotomy surgery).
• Make a diagnosis of congenital anomalies, such as pectus carinatum or pectus excavatum.
• Investigate local chest pain/swelling.
• Differentiate between benign and malignant lesions.
• Support in the planning and surgery.

Indications for the Test

It is possible to recommend MRI Sternum in case of:

• Persistent chest pains that are not connected with heart or pulmonary deficiencies.
• Sternal fracture/injury is suspected.
• Weakness or a lump in the chest.
• Chest surgery after surgery.
• Suspected infection or inflammation.
• Diagnosis of bone tumors or metastasis.
• Follow-up known sternal or mediastinal disease.

Procedure of MRI Sternum

Before the Scan

• Do not wear any metal objects (jewels, belts, piercings, etc).
• Give a report of the implants, pacemakers, and previous surgeries to the physician.
• Fasting is not a requirement.
• In case of contrast, kidney function tests might be required.

During the Scan

• The patient lies on an MRI table in a supine position.
• The area of the chest is in a special coil.
• The images are carried out in different planes (axial, sagittal, coronal).
• In case of need, contrast-enhanced imaging can be done.
• The scan takes 30-45 minutes.

After the Scan

• It is possible to restore normal functioning instantly.
• A radiologist appraises the images and reports the conclusions.

Imaging Sequences Used

• T1-weighted image: Evaluate the bone marrow and anatomy.
• T2-weighted images: Determine fluid, edema, and the soft tissue changes.
• STIR sequence: Identify marrow edema, small fractures.
• Post-contrast T1: Check tumors and infections.
• Diffusion-weighted imaging (DWI): Helps establish the activity of tumors.

Conditions Diagnosed

Trauma

• Symptomatic occult or subtle sternal fracture.
• Bone marrow edema.

Infections

• Osteomyelitis.
• Soft tissue infections or abscesses.

Tumors

• Primary tumors (i.e., chondrosarcoma, osteosarcoma, Ewing’s sarcoma).
• Metastatic breast, lung, thyroid, and kidney cancer.

Hematological Disorders

• Multiple myeloma.
• Lymphoma.

Congenital Conditions

• Deformities of the rib cage and chest wall (pectus deformities).

Post-Surgical Complications

• Non-union after sternotomy.
• Infection or chronic inflammation of the wound.

Inflammatory Conditions

• Sternoclavicular arthritis
• Sternal costochondritis.

Benefits of MRI Sternum

• No radiation exposure
• Good visualization of soft tissue.
• Sensitive to bone marrow abnormalities.
• Early symptoms of infection and inflammation.
• Application in tumor staging and treatment planning.

Risks & Limitations

• Contraindicated in patients who have some metal implants.
• Can be claustrophobic in nature.
• Implantations of metal or surgical wire can result in image artifacts.
• Excessive scan duration with respect to CT.
• Requires expert interpretation.

Conclusion

MRI Sternum is another non-invasive technique, which is safe and highly effective in imaging all forms of the sternum. Its ability to detect early marrow change as well as provide a detailed image of the soft tissues makes it better in most clinical situations. It has the ability to perform miracles by enabling it to diagnose and treat patients appropriately, which can significantly enhance their outcomes.