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Magnetic Resonance Imaging of the Pediatric Airway

Magnetic Resonance Imaging of the Pediatric Airway Abstract Objective: To determine the role of magnetic resonance imaging (MRI) and how it relates to endoscopy as well as to other imaging modalities in the evaluation of pediatric airway disorders. Design: A review study of children with various distal airway disorders over a 3-year period. Surgical procedures as well as all diagnostic imaging modalities were reviewed and analyzed with respect to clinical outcome. Setting: Academic tertiary care children's hospitals. Patients: Forty-nine children between the ages of 1 week and 14 years with the signs and symptoms of distal airway disorders. Interventions: Forty-five of 49 children underwent airway endoscopy. Fourteen children also underwent fluoroscopy and 4 underwent echocardiography. When indicated, open surgical repair was performed and used to verify findings in 32 cases. Results: Magnetic resonance imaging was the most accurate modality in defining extrinsic airway abnormalities. The findings of echocardiography were incorrect in 2 of 4 cases, and fluoroscopy, although accurate for tracheal narrowing and tracheomalacia, often could not elucidate the exact cause or missed left mainstem bronchial compression. Furthermore, tracheal narrowing to 50% or greater on MRI correlated 100% with the need for surgical intervention. Conclusions: Magnetic resonance imaging is a useful modality that has allowed us to accurately diagnose extrinsic pediatric tracheal abnormalities. In certain cases, MRI scans can be obtained prior to endoscopy. In those cases, definitive endoscopy and open repair are performed at the same procedure instead of at 2 separate procedures (ie, one for diagnostic endoscopy and the other for definitive repair).Arch Otolaryngol Head Neck Surg. 1997;123:999-1003 References 1. Hopkins KL, Patrick LE, Simoneaux SF, Bankj ER, Parks WJ, Smith SS. Pediatric great vessel anomalies: initial clinical experience with spiral CT angiography . Radiology . 1996;200:811-815.Crossref 2. Bisset GS III. Pediatric thoracic applications of magnetic resonance imaging . J Thorac Imag . 1989;4:51-57.Crossref 3. Bisset GS III, Strife JL, Kirks DR, Bailey WW. Vascular rings: MR imaging . AJR Am J Roentgenol . 1987;149:251-256.Crossref 4. Siegel JH, Nadel SN, Glazer HS, Sagel SS. Mediastinal lesions in children: comparison of CT and MR . Radiology . 1986;160:241-244.Crossref 5. Fornadley JA, Seibert DJ, Ostrov BE, Warren SE. The role of MRI when relapsing polychondritis is suspected but not proven . Int J Pediatr Otorhinolaryngol . 1995; 31:101-107.Crossref 6. Hennington MH, Detterbeck FC, Molina PL, Wood RE. Innominate artery and tracheal compression due to aberrant position of the thymus . Ann Thorac Surg . 1995;59:526-528.Crossref 7. Vogl T, Diebold T, Bergman C, et al. MRI in pre- and postoperative assessment of tracheal stenosis due to pulmonary artery sling . J Comput Assist Tomogr . 1993; 17:878-886.Crossref 8. Friese K, Duclce M, Higgins C. Airway obstruction by right aortic arch with rightsided patent ductus arteriosus: demonstration by MRI . J Comput Assist Tomogr . 1992;16:888-892.Crossref 9. Kitinaka S, Mikami I, Tokumaru A, O'Uchi T. Diagnosis of peanut inhalation by MRI . Pediatr Radio! . 1992;22:300-301.Crossref 10. Hofmann U, Hofmann D, Vogl T, Wilimzig C, Mantel K. Magnetic resonance imaging as a new diagnostic criterion in pediatric airway obstruction . Prog Pediatr Surg . 1991;27:221-230. 11. Simoneaux SF, Bank EE, Webber JB, Parks WJ. MR imaging of the pediatric airway . Radiographics . 1995;15:287-298.Crossref 12. Auringer ST, Bisset GS III, Myer CM III. Magnetic resonance imaging of the pediatric airway: compared to findings at surgery and/or endoscopy . Pediatr Radiol . 1991;21:329-332.Crossref 13. Hall JE. The physiology of respiration in infants and young children . Proc R Soc Lond . 1955;48:761-766. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1997.01900090115018
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To determine the role of magnetic resonance imaging (MRI) and how it relates to endoscopy as well as to other imaging modalities in the evaluation of pediatric airway disorders. Design: A review study of children with various distal airway disorders over a 3-year period. Surgical procedures as well as all diagnostic imaging modalities were reviewed and analyzed with respect to clinical outcome. Setting: Academic tertiary care children's hospitals. Patients: Forty-nine children between the ages of 1 week and 14 years with the signs and symptoms of distal airway disorders. Interventions: Forty-five of 49 children underwent airway endoscopy. Fourteen children also underwent fluoroscopy and 4 underwent echocardiography. When indicated, open surgical repair was performed and used to verify findings in 32 cases. Results: Magnetic resonance imaging was the most accurate modality in defining extrinsic airway abnormalities. The findings of echocardiography were incorrect in 2 of 4 cases, and fluoroscopy, although accurate for tracheal narrowing and tracheomalacia, often could not elucidate the exact cause or missed left mainstem bronchial compression. Furthermore, tracheal narrowing to 50% or greater on MRI correlated 100% with the need for surgical intervention. Conclusions: Magnetic resonance imaging is a useful modality that has allowed us to accurately diagnose extrinsic pediatric tracheal abnormalities. In certain cases, MRI scans can be obtained prior to endoscopy. In those cases, definitive endoscopy and open repair are performed at the same procedure instead of at 2 separate procedures (ie, one for diagnostic endoscopy and the other for definitive repair).Arch Otolaryngol Head Neck Surg. 1997;123:999-1003 References 1. Hopkins KL, Patrick LE, Simoneaux SF, Bankj ER, Parks WJ, Smith SS. Pediatric great vessel anomalies: initial clinical experience with spiral CT angiography . Radiology . 1996;200:811-815.Crossref 2. Bisset GS III. Pediatric thoracic applications of magnetic resonance imaging . J Thorac Imag . 1989;4:51-57.Crossref 3. Bisset GS III, Strife JL, Kirks DR, Bailey WW. Vascular rings: MR imaging . AJR Am J Roentgenol . 1987;149:251-256.Crossref 4. Siegel JH, Nadel SN, Glazer HS, Sagel SS. Mediastinal lesions in children: comparison of CT and MR . Radiology . 1986;160:241-244.Crossref 5. Fornadley JA, Seibert DJ, Ostrov BE, Warren SE. The role of MRI when relapsing polychondritis is suspected but not proven . Int J Pediatr Otorhinolaryngol . 1995; 31:101-107.Crossref 6. Hennington MH, Detterbeck FC, Molina PL, Wood RE. Innominate artery and tracheal compression due to aberrant position of the thymus . Ann Thorac Surg . 1995;59:526-528.Crossref 7. Vogl T, Diebold T, Bergman C, et al. MRI in pre- and postoperative assessment of tracheal stenosis due to pulmonary artery sling . J Comput Assist Tomogr . 1993; 17:878-886.Crossref 8. Friese K, Duclce M, Higgins C. Airway obstruction by right aortic arch with rightsided patent ductus arteriosus: demonstration by MRI . J Comput Assist Tomogr . 1992;16:888-892.Crossref 9. Kitinaka S, Mikami I, Tokumaru A, O'Uchi T. Diagnosis of peanut inhalation by MRI . Pediatr Radio! . 1992;22:300-301.Crossref 10. Hofmann U, Hofmann D, Vogl T, Wilimzig C, Mantel K. Magnetic resonance imaging as a new diagnostic criterion in pediatric airway obstruction . Prog Pediatr Surg . 1991;27:221-230. 11. Simoneaux SF, Bank EE, Webber JB, Parks WJ. MR imaging of the pediatric airway . Radiographics . 1995;15:287-298.Crossref 12. Auringer ST, Bisset GS III, Myer CM III. Magnetic resonance imaging of the pediatric airway: compared to findings at surgery and/or endoscopy . Pediatr Radiol . 1991;21:329-332.Crossref 13. Hall JE. The physiology of respiration in infants and young children . Proc R Soc Lond . 1955;48:761-766.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Sep 1, 1997

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