Ciet, Pierluigi3; Wielopolski, Piotr3; Manniesing, Rashindra4; Lever, Sandra5; de Bruijne, Marleen9; Morana, Giovanni7; Muzzio, Pier Carlo8; Lequin, Maarten H.3; Tiddens, Harm A. W. M.3
1 Administration, Department of Computer Science, Faculty of Science, Københavns Universitet2 The Image Section, Department of Computer Science, Faculty of Science, Københavns Universitet3 Erasmus Medical Center Rotterdam4 Radboud University Nijmegen Medical Centre5 Erasmus Medical Center-Sophia Children's Hospital6 Department of Computer Science, Faculty of Science, Københavns Universitet7 Ospedale Cà Foncello8 Istituto Oncologico Veneto IOV IRCCS9 Department of Computer Science, Faculty of Science, Københavns Universitet
Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard to diagnose TBM, but bronchoscopy has major disadvantages, such as general anaesthesia. Cine-CT is a non-invasive alternative to diagnose TBM, but its use in children is restricted by ionizing radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine-MRI as alternative to cine-CT in a retrospective study.12 children (mean 12 years, range 7-17), suspected to have TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration covering the thorax using a 3D SPGR sequence. 3D-Dynamic-scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter greater than 50% at end-expiration 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 7 subjects. TBM was diagnosed by cine-MRI in 7 out of 12 children (58%) and was confirmed by bronchoscopy or CT. In 4 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.
European Respiratory Journal, 2014, Vol 43, Issue 1, p. 115-124