Gräfe Daniel, Hirsch Franz Wolfgang
Institut für Kinderradiologie, Universitätsklinikum Leipzig, Liebigstraße 20A, 04103, Leipzig, Deutschland.
Radiologie (Heidelb). 2025 Jul 9. doi: 10.1007/s00117-025-01486-2.
Magnetic resonance imagining (MRI) has become a well-established radiation-free alternative to computed tomography (CT) in pediatric imaging but is still rarely used for lung evaluation due to technical limitations such as low proton density and motion artifacts.
To demonstrate how pediatric lung MRI can be performed reliably despite its known limitations and how recent technical innovations enhance its diagnostic potential.
Based on clinical experience from a university pediatric radiology center, a standardized thoracic MRI protocol for children is presented. It includes respiratory-triggered T2-weighted sequences and, when available, ultra-short TE (UTE) sequences. Emerging techniques such as ventilation-perfusion MRI and real-time MRI are also discussed.
Most clinical questions can be addressed using respiratory-triggered T2-weighted sequences. UTE sequences improve visualization of aerated lung parenchyma and low-proton lesions. Real-time MRI significantly reduces motion artifacts and enables functional assessment, especially in unsedated infants and toddlers. Total exam time is 15-20 min.
Pediatric lung MRI is a reliable, radiation-free alternative to CT in many cases. New sequence techniques like UTE and real-time MRI considerably expand its diagnostic range. Wider adoption could meaningfully reduce radiation exposure in children with chronic lung disease.
在儿科影像检查中，磁共振成像（MRI）已成为一种成熟的、无辐射的计算机断层扫描（CT）替代方法，但由于诸如质子密度低和运动伪影等技术限制，其在肺部评估中的应用仍很少见。
展示尽管存在已知局限性，小儿肺部MRI仍可可靠地进行，以及近期的技术创新如何增强其诊断潜力。
基于一所大学儿科放射中心的临床经验，提出了一种针对儿童的标准化胸部MRI方案。它包括呼吸触发的T2加权序列，以及在可行时的超短TE（UTE）序列。还讨论了通气灌注MRI和实时MRI等新兴技术。
大多数临床问题可以通过呼吸触发的T2加权序列解决。UTE序列改善了充气肺实质和低质子病变的可视化。实时MRI显著减少运动伪影，并能够进行功能评估，尤其是在未使用镇静剂的婴幼儿中。总检查时间为15 - 20分钟。
在许多情况下，小儿肺部MRI是一种可靠的、无辐射的CT替代方法。UTE和实时MRI等新序列技术大大扩展了其诊断范围。更广泛地采用可以显著减少慢性肺病患儿的辐射暴露。
