Zanette Brandon, Greer Mary-Louise C, Moraes Theo J, Ratjen Felix, Santyr Giles
Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada.
Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.
Expert Rev Respir Med. 2023 Jul-Dec;17(7):527-538. doi: 10.1080/17476348.2023.2241355. Epub 2023 Jul 28.
Although historically challenging to perform in the lung, technological advancements have made Magnetic Resonance Imaging (MRI) increasingly applicable for pediatric pulmonary imaging. Furthermore, a wide array of functional imaging techniques has become available that may be leveraged alongside structural imaging for increasingly sensitive biomarkers, or as outcome measures in the evaluation of novel therapies.
In this review, recent technical advancements and modern methodologies for structural and functional lung MRI are described. These include ultrashort echo time (UTE) MRI, free-breathing contrast agent-free, functional lung MRI, and hyperpolarized gas MRI, amongst other techniques. Specific examples of the application of these methods in children are provided, principally drawn from recent research in asthma, bronchopulmonary dysplasia, and cystic fibrosis.
Pediatric lung MRI is rapidly growing, and is well poised for clinical utilization, as well as continued research into early disease detection, disease processes, and novel treatments. Structure/function complementarity makes MRI especially attractive as a tool for increased adoption in the evaluation of pediatric lung disease. Looking toward the future, novel technologies, such as low-field MRI and artificial intelligence, mitigate some of the traditional drawbacks of lung MRI and will aid in improving access to MRI in general, potentially spurring increased adoption and demand for pulmonary MRI in children.
尽管从历史角度来看,在肺部进行磁共振成像(MRI)具有挑战性,但技术进步已使MRI越来越适用于儿科肺部成像。此外,一系列功能成像技术已经出现,可与结构成像一起用于寻找更敏感的生物标志物,或作为评估新疗法的疗效指标。
在本综述中,描述了用于肺部结构和功能MRI的最新技术进展和现代方法。这些技术包括超短回波时间(UTE)MRI、自由呼吸无对比剂功能肺部MRI和超极化气体MRI等。文中提供了这些方法在儿童中的具体应用实例,主要取材于近期在哮喘、支气管肺发育不良和囊性纤维化方面的研究。
儿科肺部MRI正在迅速发展,已做好临床应用的准备,同时也将继续用于早期疾病检测、疾病进程和新疗法的研究。结构/功能互补性使MRI作为一种工具在儿科肺部疾病评估中更具吸引力。展望未来,诸如低场MRI和人工智能等新技术可缓解肺部MRI的一些传统缺点,并有助于总体上改善MRI的可及性,可能会促使儿科肺部MRI的应用和需求增加。