Lung MRI in Children: The Road Less Travelled

Sodhi, Kushaljit Singh

doi:10.1055/s-0041-1729126

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Due to increasing concerns about potentially harmful effects on imaging techniques based on exposure to ionizing radiation in children, in particular in those affected with syndromic DNA reparation defects, MRI of the respiratory system plays an important role in diagnosing and monitoring a spectrum of thoracic disorders. MRI has been adopted for evaluation of the diseases in the lung parenchyma, interstitial lung disease, disorders of large as well as medium and small airways, abnormalities of thoracic vasculature, pleural diseases, masses, and chest wall pathologies (44)(45)(46)(47)(48)(49)(50). The role of MRI in neuroimaging and investigating neurodegeneration in A-T has also been recently defined in several reports (51,52).…”

Section: Patientmentioning

confidence: 99%

Imaging in children with ataxia-telangiectasia—The radiologist’s approach

2022

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Ataxia-telangiectasia (A-T) is a syndromic inborn error of immunity (IEI) characterized by genomic instability, defective reparation of the DNA double-strand breaks, and hypersensitivity to ionizing radiation disturbing cellular homeostasis. The role of imaging diagnostics and the conscious choice of safe and advantageous imaging technique, as well as its correct interpretation, are crucial in the diagnostic process and monitoring of children with A-T. This study aimed at defining the role of a radiologist in the early diagnosis of A-T, as well as in detecting and tracking disease complications associated with infections, inflammation, lymphoproliferation, organ-specific immunopathology, and malignancy. Based on our singlecenter experience, retrospective analysis of investigations using ionizing radiation-free techniques, ultrasound (US), and Magnetic Resonance Imaging (MRI), was performed on regularly followed-up 11 pediatric A-T patients, 6 girls and 5 boys, aged from 2 to 18 years, with the longest period of observation coming to over 13 years. Our attention was especially drawn to the abnormalities that were observed in the US and MRI examinations of the lungs, abdominal cavity, and lymph nodes. The abdominal US showed no abnormalities in organ dimensions or echostructure in 4 out of 11 children studied, yet in the other 7, during follow-up examinations, hepatoand/or splenomegaly, mesenteric, visceral, and paraaortic lymphadenopathy were observable. In 2 patients, focal changes in the liver and spleen were shown, and in one patient progressive abdominal lymphadenopathy corresponded with the diagnosis of non-Hodgkin lymphoma (NHL). The lung US revealed multiple subpleural consolidations and B line artifacts related to the interstitial-alveolar syndrome in 5 patients, accompanied by pleural effusion in one of them. The MRI investigation of the lung enabled the detection of lymphatic nodal masses in the mediastinum, with concomitant airway lesions characteristic of bronchiectasis and focal parenchymal consolidations in one A-T patient with chronic respiratory failure. This patient also manifested organomegaly and granulomatous liver disease Frontiers in Pediatrics 01 frontiersin.org Jończyk-Potoczna et al. 10.3389/fped.2022.988645 in abdominal MRI examination. Our study shows that the use of modern US capabilities and MRI is safe and efficient, thereby serving as a recommended advantageous imaging diagnostic tool in monitoring children with IEI and DNA instability syndromes.

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Section: Patientmentioning

confidence: 99%

Imaging in children with ataxia-telangiectasia—The radiologist’s approach

2022

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“…Under the assumption that pulmonary function testing is not sensitive enough for subclinical disease progression, imaging plays an important role in clinical monitoring Because of the complete calcification, the nodule remains invisible on the MR scan and research of CF lung disease. More than any other imaging modality, MRI offers structural and functional imaging without radiation exposure [49,50] (Fig. 7).…”

Section: Airway Diseasementioning

confidence: 99%

Practical protocol for lung magnetic resonance imaging and common clinical indications

et al. 2021

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Imaging speed, spatial resolution and availability have made CT the favored cross-sectional imaging modality for evaluating various respiratory diseases of children — but only for the price of a radiation exposure. MRI is increasingly being appreciated as an alternative to CT, not only for offering three-dimensional (3-D) imaging without radiation exposure at only slightly inferior spatial resolution, but also for its superior soft-tissue contrast and exclusive morpho-functional imaging capacities beyond the scope of CT. Continuing technical improvements and experience with this so far under-utilized modality contribute to a growing acceptance of MRI for an increasing number of indications, in particular for pediatric patients. This review article provides the reader with practical easy-to-use protocols for common clinical indications in children. This is intended to encourage pediatric radiologists to appreciate the new horizons for applications of this rapidly evolving technique in the field of pediatric respiratory diseases.

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