Magnetic Resonance Imaging of Pediatric Lungs and Airways: New Paradigm for Practical Daily Clinical Use.

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Thoracic Imaging Pub Date : 2024-01-01 Epub Date: 2023-03-31 DOI:10.1097/RTI.0000000000000707
Mark C Liszewski, Pierluigi Ciet, Abbey J Winant, Edward Y Lee
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Abstract

Disorders of the lungs and airways are among the most common indications for diagnostic imaging in infants and children. Traditionally, chest radiograph has been the first-line imaging test for detecting these disorders and when cross-sectional imaging is necessary, computed tomography (CT) has typically been the next step. However, due to concerns about the potentially harmful effects of ionizing radiation, pediatric imaging in general has begun to shift away from CT toward magnetic resonance imaging (MRI) as a preferred modality. Several unique technical challenges of chest MRI, including motion artifact from respiratory and cardiac motion as well as low signal-to-noise ratios secondary to relatively low proton density in the lung have slowed this shift in thoracic imaging. However, technical advances in MRI in recent years, including developments in non-Cartesian MRI data sampling methods such as radial, spiral, and PROPELLER imaging and the development of ultrashort TE and zero TE sequences that render CT-like high-quality imaging with minimal motion artifact have allowed for a shift to MRI for evaluation of lung and large airways in centers with specialized expertise. This article presents a practical approach for radiologists in current practice to begin to consider MRI for evaluation of the pediatric lung and large airways and begin to implement it in their practices. The current role for MRI in the evaluation of disorders of the pediatric lung and large airways is reviewed, and example cases are presented. Challenges for MRI of the lung and large airways in children are discussed, practical tips for patient preparation including sedation are described, and imaging techniques suitable for current clinical practice are presented.

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小儿肺和气道的磁共振成像:实用日常临床应用的新范例。
肺部和气道疾病是婴幼儿诊断成像最常见的适应症之一。传统上,胸片是检测这些疾病的一线成像检查方法,当需要进行横断面成像时,计算机断层扫描(CT)通常是下一步检查方法。然而,由于担心电离辐射的潜在危害,儿科成像已开始从 CT 转向磁共振成像 (MRI) 作为首选方式。胸部核磁共振成像存在一些独特的技术难题,包括呼吸和心脏运动造成的运动伪影,以及肺部质子密度相对较低导致的低信噪比,这些都减缓了胸部成像的转变。然而,近年来磁共振成像技术的进步,包括非笛卡尔磁共振成像数据取样方法(如径向、螺旋和 PROPELLER 成像)的发展,以及超短 TE 和零 TE 序列的开发,这些技术可提供类似 CT 的高质量成像,同时将运动伪影降到最低。本文介绍了一种实用的方法,让放射科医生在目前的实践中开始考虑用磁共振成像评估小儿肺部和大气管,并开始在他们的实践中实施。文章回顾了磁共振成像目前在评估小儿肺部和大气管疾病中的作用,并列举了一些病例。讨论了儿童肺部和大气道核磁共振成像所面临的挑战,介绍了包括镇静在内的患者准备实用技巧,并介绍了适合当前临床实践的成像技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Thoracic Imaging
Journal of Thoracic Imaging 医学-核医学
CiteScore
7.10
自引率
9.10%
发文量
87
审稿时长
6-12 weeks
期刊介绍: Journal of Thoracic Imaging (JTI) provides authoritative information on all aspects of the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Original articles and analytical reviews published in this timely journal provide the very latest thinking of leading experts concerning the use of chest radiography, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and all other promising imaging techniques in cardiopulmonary radiology. Official Journal of the Society of Thoracic Radiology: Japanese Society of Thoracic Radiology Korean Society of Thoracic Radiology European Society of Thoracic Imaging.
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