Abstract
Objective: There has been increased interest in magnetic resonance imaging (MRI) of the lung parenchyma in recent years. We aimed to evaluate the pulmonary MRI findings of patients in the light of literature data in this study.
Material
and
Methods: Fifteen patients who underwent pulmonary MR imaging between April 2017 and January 2018 were included in our study. Demographic information, clinical preliminary diagnosis and imaging findings of the patients were retrospectively evaluated. Axial and coronal T2-weighted (T2W) and axial fat-saturated T2W images were obtained from all patients.
Results:The mean age of the patients (7 girls, 8 boys) was 7.8 years (5 months -18 years). Lung MRI was used for the diagnosis of neutropenia-related infection during follow-up for hematologic-oncological diseases (n=6), lung hydatid cyst and follow-up of complications (n=2), metastasis scan (n=2), empyema diagnosis and/or follow-up of treatment (n=4), and lung mass-infection distinction (n=1). Twelve of the children were also imaged with computed tomography before lung MRI. In the follow-up MR imaging of patients with neutropenia and lung infection; the nodules and consolidated areas disappeared and became smaller in three patients, the number of nodules increased in one patient, and the number of nodules remained stable but became cavitated in one patient. In the patient with Fanconi aplastic anemia, a diagnosis of fungal infection was made by showing the reverse target sign on MRI. Patients with lung hydatid cyst and tuberculosis were differentiated from a lung mass easily. In the follow-up of three patients with necrotizing pneumonia
and empyema, the empyema/parenchymal infection findings were shown to be improved and one patient’s empyema associated with parenchymal consolidation was diagnosed with MRI.
Conclusion: MRI has promising results in imaging parenchymal diseases of the lung. The most important advantage of MRI is the lack of radiation. MRI is useful in the diagnosis and follow-up of lung infections and complications in children, especially those who are immunocompromised or sensitive to radiation.
Keywords: Lung, Child, Infection, Immunocompromised
References
- 1. Yan C, Tan X, Wei Q, Feng R, Li C, Wu Y, et al. Lung MRI of
- invasive fungal infection at 3 Tesla: Evaluation of five different
- pulse sequences and comparison with multidetector computed
- tomography (MDCT). Eur Radiol 2015;25:550-7.
- 2. Ozcan HN, Gormez A, Ozsurekci Y, Karakaya J, Oguz B, Unal
- S, et al. Magnetic resonance imaging of pulmonary infection in
- immunocompromised children: Comparison with multidetector
- computed tomography. Pediatr Radiol 2017;47:146-53.
- 3. Ekinci A, Yücel Uçarkuş T, Okur A, Öztürk M, Doğan S. MRI of
- pneumonia in immunocompromised patients: comparison with CT.
- Diagn Interv Radiol 2017;23:22-8.
- 4. Leutner CC, Gieseke J, Lutterbey G, Kuhl CK, Glasmacher
- A, Wardelmann E, et al. MR imaging of pneumonia in
- immunocompromised patients: Comparison with helical CT. Am J
- Roentgenol 2000;175:391-7.
- 5. Peltola V, Ruuskanen O, Svedström E. Magnetic resonance imaging
- of lung infections in children. Pediatr Radiol 2008;38:1225-31.
- 6. Bruegel M, Gaa J, Woertler K, Ganter C, Waldt S, Hillerer C, et
- al. MRI of the lung: Value of different turbo spin-echo, singleshot
- turbo spin-echo, and 3D gradient-echo pulse sequences for
- the detection of pulmonary metastases. J Magn Reson Imaging
- 2007;25:73-81.
- 7. Vogt FM, Herborn CU, Hunold P, Lauenstein TC, Schröder T,
- Debatin JF, et al. HASTE MRI versus chest radiography in the
- detection of pulmonary nodules: Comparison with MDCT. Am J
- Roentgenol 2004;183:71–8.
- 8. Sodhi KS, Khandelwal N, Saxena AK, Bhatia A, Bansal D,
- Trehan A, et al. Rapid lung MRI paradigm shift in evaluation of
- febrile neutropenia in children with leukemia: A pilot study. Leuk
- Lymphoma 2016; 57:70-5.
- 9. Sodhi KS, Bhatia A, Khandelwal N. Rapid lung magnetic resonance
- imaging in children with pulmonary infection. Pediatr Radiol 2017;
- 47:764-5.
- 10. Brody AS, Frush DP, Huda W, Brent RL; American Academy of
- Pediatrics Section on Radiology. Radiation risk to children from
- computed tomography. Pediatrics 2007;120:677–82.
- 11. Sieren JC, Ohno Y, Koyama H, Sugimura K, McLennan G.
- Recent technological and application developments in computed
- tomography and magnetic resonance imaging for improved
- pulmonary nodule detection and lung cancer staging. J Magn
- Reson Imaging 2010;32:1353–69.
- 12. Rupprecht T, Bowing B, Kuth R, Deimling M, Rascher W, Wagner
- M. Steady-state free precession projection MRI as a potential
- alternative to the conventional chest X-ray in pediatric patients with
- suspected pneumonia. Eur Radiol 2002;12:2752–6.
- 13. Yikilmaz A, Koc A, Coskun A, Ozturk MK, Mulkern RV, Lee EY.
- Evaluation of pneumonia in children: Comparison of MRI with fast
- imaging sequences at 1.5T with chest radiographs. Acta Radiol
- 2011;52:914– 9.
- 14. Kim WS, Moon WK, Kim IO, Lee HJ, Im JG, Yeon KM, et al.
- Pulmonary tuberculosis in children: Evaluation with CT. Am J
- Roentgenol 1997;168:1005-9.