A Novel Approach to Lung Imaging in Children: Magnetic Resonance Imaging

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