Abdulhakim Coskun MD, Presenter: Nothing to Disclose

Ali Koc, Abstract Co-Author: Nothing to Disclose

Ali Yikilmaz MD, Abstract Co-Author: Nothing to Disclose

Mustafa Ozturk, Abstract Co-Author: Nothing to Disclose

Edward Yungjae Lee MD, Abstract Co-Author: Nothing to Disclose

To assess the efficacy of MRI with short imaging sequences in evaluating pediatric pneumonia by comparing MRI findings with those of CXR.

This prospective study includes 40 pediatric patients (24M, 16F; av. 7.3 y/o) with pneumonia from 12/1/2004 to 5/31/2006. CXR immediately followed by MRI (1.5T) were obtained in all patients. MR images were obtained in axial and coronal planes with two different short imaging sequences: T1-weighted FFE IP (Fast Field Echo Inversion Prepulse) (TR/TE: 83/4.6) and T2-weighted B-FFE M2D (Balanced Fast Field Echo Multiple 2 Dimensional) (TR/TE: 3.2/1.6). Other MRI parameters include slice thickness of 15-20 mm; matrix size of 256 x 256; FOV of 375-395 mm; flip angle of 60-80º; and total scanning time of 70s. CXR and MRI images were evaluated for consolidation, bronchiectasis, lung abscess/ necrosis, pleural effusion, and pleural fluid-thickening by two experienced pediatric radiologists independently and in blinded fashion. CXR and MRI findings were compared with McNemar Test (p values < 0.05—a statistically significant difference).

Consolidation was detected in 37 patients with CXR and 38 patients with MRI. All consolidations detected with CXR were also detected with MRI. In 9 patients, MRI showed additional consolidations not seen with CXR. Bronchiectasis was detected in 2 patients with CXR and 5 patients with MRI. Lung abscess/necrosis was detected in 6 patients solely with MRI. Pleural effusion-thickening was detected in 11 patients with CXR and 27 patients with MRI. Although the difference between CXR and MRI in detecting consolidation and bronchiectasis was not statistically significant, MRI was proven superior to CXR in detecting lung abscess/necrosis and pleural effusion-thickening (p < 0.05).

With short imaging sequences, MRI is superior to CXR in evaluating lung abscess/necrosis and pleural effusion/thickening, while MRI and CXR perform equally well in assessing consolidation and bronchiectasis in pediatric pneumonia.

MRI, when performed in short scanning sequences and without ionizing radiation exposure, is a promising modality, particularly in evaluating an infectious process such as pneumonia in children.

Coskun, A, Koc, A, Yikilmaz, A, Ozturk, M, Lee, E, Comparison of MRI with Short Imaging Sequences and CXR for Evaluation of Pneumonia in Pediatric Patients.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5008213.html