Stories about: pulmonology

Has lung MRI for children come of age?

Chest MRI and CT scans from a child
With the latest technologies and techniques, MRI (bottom) is in many cases just as good as, if not better than, CT (top) when taking images of a child's chest. (Courtesy Edward Y. Lee, MD, MPH)

Magnetic resonance imaging, or MRI, can produce stunningly detailed images of the body’s tissues and structures. Historically, however, the chest—and in particular, the lungs and airway—has proven challenging for radiologists to clearly visualize through MR images.

Why is that? Unlike most other solid organs, the lung and trachea aren’t really solid. The air spaces within them do not absorb the magnetic fields or produce the radio signals needed to generate high-quality diagnostic images. Also, they are in constant motion—we have to breathe, after all.

For these reasons, radiologists have long relied on x-rays and computed tomography (CT) scans to take pictures of the lungs. Both can produce very good, highly detailed diagnostic images, but both also come with risks related to their reliance on ionizing radiation.

The lung MRI’s time may now have come. In a review paper in Radiologic Clinics of North America (RCNA), an international team of radiologists led by Simon Warfield, PhD, and Edward Y. Lee, MD, MPH, of Boston Children’s Department of Radiology outlines several recent advances that have made MRI a more viable—radiation-free—alternative for diagnostic imaging of children’s lungs and airway.

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Peeking into the black box of lung ventilation

As the lungs expand, the glow blue in this movie made using EIT; areas that are underinflated appear red.
Can we monitor a child's lungs when they're on a ventilator without actually taking a picture? Yes, with a technology called EIT; click the image above to see for yourself. (Courtesy Camille Gómez-Laberge)

Every year, thousands of children in intensive care units across the United States are put on mechanical ventilation to help them breathe. But while this technology has saved countless lives, it can also cause or worsen lung injury.

“A child’s injured lungs don’t often inflate uniformly under ventilation,” says Gerhard Wolf, a critical care doctor in Children’s Hospital Boston’s Department of Anesthesia. “So one part of the lung may be nearly collapsed while another is overinflated. We need to be able to see that so we don’t cause further damage.”

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