| Abstract [eng] |
Sarcoidosis is a systemic disease of unknown etiology, characterized by noncaseating granulomas. It can affect various organs, but most commonly the lungs and thoracic lymph nodes. Imaging studies are important in the diagnosis of pulmonary sarcoidosis, especially chest radiography, computed tomography, and positron emission tomography with computed tomography. However, these methods have disadvantages, the most important of which may be ionizing radiation, which is why interest in non-ionizing magnetic resonance imaging as a possible alternative is growing. Though long considered unsuitable for lung imaging, technological advances have expanded its potential, yet its role in pulmonary sarcoidosis diagnosis remains underappreciated. The aim of this literature review is to review and summarize the possibilities of magnetic resonance imaging in the diagnosis of pulmonary sarcoidosis. A literature search was performed using PubMed and Google Scholar databases. Publications in English corresponding to the topic of the work and published from 2010 to 2025 were included. Keywords used: sarcoidosis, pulmonary sarcoidosis, pulmonary sarcoidosis imaging, pulmonary sarcoidosis MRI. Studies have shown agreement and correlation between magnetic resonance imaging and other commonly used imaging methods (chest radiography and computed tomography). However, it has been observed that magnetic resonance imaging, due to low proton density in the lungs and artifacts, both contributing to reduced spatial resolution, was less effective than computed tomography in visualizing small changes in the lungs, although magnetic resonance images better corresponded to clinically significant progression. Also, the potential of magnetic resonance imaging in determining the activity of pulmonary sarcoidosis was observed: late gadolinium enhancement on contrast-enhanced T1 sequences is more associated with fibrotic (inactive) changes, and a more intense signal on T2 sequences with inflammatory (active) changes. Additional benefits of magnetic resonance imaging have been observed in thoracic lymph node imaging: dark lymph node sign associated with sarcoidosis, diffusion-weighted images together with apparent diffusion coefficient maps may be useful in the differential diagnosis of this disease. In conclusion, magnetic resonance imaging can visualize changes characteristic of pulmonary sarcoidosis and be valuable in monitoring the progression of this disease. This imaging study is also promising in assessing the activity of pulmonary sarcoidosis and lymph node damage characteristic of this disease. However, although magnetic resonance imaging has potential in the diagnosis of pulmonary sarcoidosis, there are few studies so far, and its application is additionally limited by lower availability, so today it does not replace conventional imaging studies, but can be used as an alternative in case of contraindications to them or as an additional imaging method. |
