Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients

Abstract

Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard for diagnosing TBM; however it has major disadvantages, such as general anaesthesia. Cine computed tomography (CT) is a noninvasive alternative used to diagnose TBM, but its use in children is restricted by ionising radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine magnetic resonance imaging (MRI) as an alternative to cine-CT in a retrospective study.12 children with a mean age (range) of 12 years (7-17 years), suspected of having TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration covering the thorax using a threedimensional spoiled gradient echo sequence. Three-dimensional dynamic scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter .50% at endexpiration in the static and dynamic scans.The success rate of the cine-MRI protocol was 92%. Cine-MRI was compared with bronchoscopy or chest CT in seven subjects. TBM was diagnosed by cine-MRI in seven (58%) out of 12 children and was confirmed by bronchoscopy or CT. In four patients, cine-MRI demonstrated tracheal narrowing that was not present in the static scans.Spirometer controlled cine-MRI is a promising technique to assess TBM in children and has the potential to replace bronchoscopy. @ERSpublications Spirometer controlled cine-MRI: a technique to assess TBM in children with the potential to replace bronchoscopy/cine-CT http://ow.ly/pDNAA

Paediatric tracheomalacia - A review of clinical features and comparison of diagnostic imaging techniques

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“…MRI as radiation-free technique offers also new techniques for dynamic tracheobronchial imaging such as the spirometer-controlled Cine-MRI [42]. This method provides the possibility to study airway dimensions during varying static and dynamic manoeuvres such as forced expiration or cough [42].…”

“…This method provides the possibility to study airway dimensions during varying static and dynamic manoeuvres such as forced expiration or cough [42]. However, the need of an MRI compatible metal-free spirometer and an additional scan time of about 15 min represent 2 major disadvantages of this method making the use in young children almost impossible [42]. Another promising tool could be Cine-MRI of the tracheal dynamics.…”