Structural and perfusion magnetic resonance imaging of congenital lung malformations
pubmed.ncbi.nlm.nih.gov shows its articles on its own site.
Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Sep 2020 · 1 min read
In brief
In brief
This study demonstrates that MRI with respiratory-gated sequences and dynamic perfusion imaging can accurately classify congenital lung malformations in children without radiation exposure. The protocol achieved 96% diagnostic accuracy across 39 pediatric patients with various bronchopulmonary anomalies, offering a safe alternative to CT for postnatal evaluation.
Written by the GCMD Library team from the article.
Background: A radiation-free advanced imaging modality is desirable for investigating congenital thoracic malformations in young children.
Objective: To describe magnetic resonance imaging (MRI) findings of congenital bronchopulmonary foregut malformations and investigate the ability of lung MRI for their classification.
Materials and methods: This is a retrospective analysis of consecutive MRI examinations performed for suspected congenital lung anomalies in 39 children (median age: 3.8 months, range: 2 days-15 years). Morphological and perfusion findings were characterised on respiratory-gated fast spin echo and dynamic contrast-enhanced sequences obtained at 1.5 tesla. Abnormalities were classified independently by two readers and compared to an expert diagnosis based on pathology, surgery and/or other imaging.
Results: Main diagnoses included bronchopulmonary lesions in 33 patients, scimitar syndrome in 4 patients, pulmonary arteriovenous malformation and oesophageal duplication cyst in one patient each. Of 46 observed abnormalities, 44 (96%) were classified correctly with very good interobserver agreement (96% concordance rate). The 39 detected lung lesions included isolated overinflation (17/39, 44%), cystic pulmonary airway malformation (8/39, 21%), bronchopulmonary sequestration (7/39, 18%), bronchogenic cyst (4/39, 10%) and hybrid lesion (3/39, 8%). All lung lesions presented as perfusion defect at peak pulmonary enhancement. Non-cystic lesions showed a delayed peak (median delay: 2.8 s, interquartile range: 0.5 to 4.0 s) in relation to normal lung parenchyma.
Conclusion: A dedicated lung MRI protocol including respiratory compensated sequences, dynamic angiography and perfusion is able to reliably delineate parenchymal and vascular components of congenital bronchopulmonary foregut malformations. Therefore, MRI may be considered for comprehensive postnatal evaluation of congenital thoracic malformations.
DOI: 10.1007/s00247-020-04658-5