title: Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients.
abstract: Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard for diagnosing TBM; however it has major disadvantages, such as general anaesthesia. Cine computed tomography (CT) is a noninvasive alternative used to diagnose TBM, but its use in children is restricted by ionising radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine magnetic resonance imaging (MRI) as an alternative to cine-CT in a retrospective study. 12 children with a mean age (range) of 12 years (7-17 years), suspected of having TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration covering the thorax using a three-dimensional spoiled gradient echo sequence. Three-dimensional dynamic scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter >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 seven subjects. TBM was diagnosed by cine-MRI in seven (58%) out of 12 children and was confirmed by bronchoscopy or CT. In four 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.
authors.affiliation: Erasmus Medical Center, Rotterdam.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Ciet
authors.forename: Piotr
authors.initials: P
authors.lastname: Wielopolski
authors.forename: Rashindra
authors.initials: R
authors.lastname: Manniesing
authors.forename: Sandra
authors.initials: S
authors.lastname: Lever
authors.forename: Marleen
authors.initials: M
authors.lastname: de Bruijne
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morana
authors.forename: Pier Carlo
authors.initials: PC
authors.lastname: Muzzio
authors.forename: Maarten H
authors.initials: MH
authors.lastname: Lequin
authors.forename: Harm A W M
authors.initials: HA
authors.lastname: Tiddens
mesh_terms: D000293:Adolescent; D001999:Bronchoscopy; D002648:Child; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D012119:Respiration; D012189:Retrospective Studies; D013147:Spirometry / Q000379:methods; D014057:Tomography, X-Ray Computed; D055089:Tracheobronchomalacia / Q000175:diagnosis*