title: Chest MR imaging in the follow-up of pulmonary alterations in paediatric patients with middle lobe syndrome: comparison with chest X-ray.
abstract: OBJECTIVE
  The authors evaluated the role of magnetic resonance (MR) imaging of the chest in comparison with chest X-ray in the follow-up of pulmonary abnormalities detected by computed tomography (CT) in paediatric patients with middle lobe syndrome.
  
  
  METHODS
  Seventeen patients with middle lobe syndrome (mean age 6.2 years) underwent chest CT at the time of diagnosis (100 kV, CARE dose with quality reference of 70 mAs; collimation 24×1.2 mm; rotation time 0.33 s; scan time 5 s); at follow-up after a mean of 15.3 months, all patients were evaluated with chest MR imaging with a respiratory-triggered T2-weighted BLADE sequence (TR 2,000; TE 27 ms; FOV 400 mm; flip angle 150°; slice thickness 5 mm) and chest X-ray. Images from each modality were assessed for the presence of pulmonary consolidations, bronchiectases, bronchial wall thickening and mucous plugging. Hilar and mediastinal lymphadenopathies were assessed on CT and MR images.
  
  
  RESULTS
  Baseline CT detected consolidations in 100% of patients, bronchiectases in 35%, bronchial wall thickening in 53% and mucous plugging in 35%. MR imaging and chest X-ray identified consolidations in 65% and 35%, bronchiectases in 35% and 29%, bronchial wall thickening in 59% and 6% and mucous plugging in 25% and 0%, respectively. Lymphadenopathy was seen in 64% of patients at CT and in 47% at MR imaging.
  
  
  CONCLUSIONS
  Patients with middle lobe syndrome show a wide range of parenchymal and bronchial abnormalities at diagnosis. Compared with MR imaging, chest X-ray seems to underestimate these changes. Chest MR imaging might represent a feasible and radiation-free option for an overall assessment of the lung in the follow-up of patients with middle lobe syndrome.
authors.affiliation: Department of Radiological Sciences, University of Rome "Sapienza", Rome, Italy. francesco.fraioli@uniroma1.it
authors.forename: F
authors.initials: F
authors.lastname: Fraioli
authors.forename: G
authors.initials: G
authors.lastname: Serra
authors.forename: G
authors.initials: G
authors.lastname: Ciarlo
authors.forename: V
authors.initials: V
authors.lastname: Massaccesi
authors.forename: S
authors.initials: S
authors.lastname: Liberali
authors.forename: A
authors.initials: A
authors.lastname: Fiorelli
authors.forename: F
authors.initials: F
authors.lastname: Macrì
authors.forename: C
authors.initials: C
authors.lastname: Catalano
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008878:Middle Lobe Syndrome / Q000000981:diagnostic imaging / Q000473:pathology*; D013902:Radiography, Thoracic / Q000379:methods*; D014057:Tomography, X-Ray Computed