title: Rapid lung MRI in children with pulmonary infections: Time to change our diagnostic algorithms.
abstract: BACKGROUND
  To determine the diagnostic utility of a new rapid MRI protocol, as compared with computed tomography (CT) for the detection of various pulmonary and mediastinal abnormalities in children with suspected pulmonary infections.
  
  
  METHODS
  Seventy-five children (age range of 5 to 15 years) with clinically suspected pulmonary infections were enrolled in this prospective study, which was approved by the institutional ethics committee. All patients underwent thoracic MRI (1.5T) and CT (64 detector) scan within 48 h of each other. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI were evaluated with CT as a standard of reference. Inter-observer agreement was measured with the kappa coefficient.
  
  
  RESULTS
  MRI with a new rapid MRI protocol demonstrated sensitivity, specificity, PPV, and NPV of 100% for detecting pulmonary consolidation, nodules (>3 mm), cyst/cavity, hyperinflation, pleural effusion, and lymph nodes. The kappa-test showed almost perfect agreement between MRI and multidetector CT (MDCT) in detecting thoracic abnormalities (k = 0.9). No statistically significant difference was observed between MRI and MDCT for detecting thoracic abnormalities by the McNemar test (P = 0.125).
  
  
  CONCLUSIONS
  Rapid lung MRI was found to be comparable to MDCT for detecting thoracic abnormalities in pediatric patients with clinically suspected pulmonary infections. It has a great potential as the first line cross-sectional imaging modality of choice in this patient population. However, further studies will be helpful for confirmation of our findings.
authors.affiliation: Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: Kushaljit Singh
authors.initials: KS
authors.lastname: Sodhi
authors.affiliation: Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
authors.affiliation: Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: Akshay Kumar
authors.initials: AK
authors.lastname: Saxena
authors.affiliation: Department of Paediatrics, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: Meenu
authors.initials: M
authors.lastname: Singh
authors.affiliation: Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Agarwal
authors.affiliation: Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: Anmol
authors.initials: A
authors.lastname: Bhatia
authors.affiliation: Departments of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000737:chemistry; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013909:Thorax / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: CT; MRI; children; infections; lung