MRI 2.0

Background information

Although chest Magnetic Resonance Imaging (MRI) technology has improved, acquiring high-resolution scans of the lungs is still problematic. One of the problems is a low signal-to-noise ratio due to low proton density and motion sensitivity. A patient needs to move as little as possible, which is especially challenging for children. MRI, however, has advantages over CT that justify its further development. The most important advantage is the absence of ionizing radiation, which allows for frequent scanning and assessing functional aspects of the lung and airways and of perfusion. Another important advantage is better tissue characterization compared to CT.

Overall aim

The aim of this projects is to investigate the usefulness of MRI as an alternative diagnostic technique to assess the upper and central airways and to assess lung parechyma in children with various airway and lung diseases.

Research method

This project will consist of three studies:

1. A prospective study including all children who have undergone open airways surgery of a laryngeal stenosis; respiratory and vocal sequelae will be compared to (dynamic) MRI findings.
2. A study in two parts:
   a) The MRI visualization of pulmonary changes in infants with bronchopulmonary dysplasia.
   b) The development and feasibility testing of lung MRI in neonates with bronchopulmonary dysplasia. The image shows the neonatal MRI coil used in this project. 
3. A prospective study including all children who have undergone surgical correction for a tracheoesophageal fistula; respiratory sequelae will be compared to (dynamic) MRI findings.
   
   

Desirable outcome

With this research project we hope to further develop MRI as a safe method for the imaging of pediatric airways and lung parenchyma.

Collaboration within Erasmus MC

• Neonatology.
• Ear, nose and throat surgery.
• Child surgery.
• Children's lung diseases.
• Radiology.

Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging.
Ciet P, Tiddens HA, Wielopolski PA, Wild JM, Lee EY, Morana G, Lequin MH. (2015). Pediatr Radiol. 2015 Dec;45(13):1901-15.

Characteristics and surgical outcome of 98 infants and children surgically treated for a laryngotracheal stenosis after endotracheal intubation: excellent outcome for higher grades of stenosis after SS-LTR.
Pullens B, Hoeve LJ, Timmerman MK, van der Schroeff MP, Joosten KF. (2014). Int J Pediatr Otorhinolaryngol. 2014 Sep;78(9):1444-8.

Voice outcome and voice-related quality of life after surgery for pediatric laryngotracheal stenosis.
Pullens B, Hakkesteegt M, Hoeve H, Timmerman M, Joosten K. (2017). Laryngoscope. 2017 Jul;127(7):1707-1711.

Newer Imaging Techniques for Bronchopulmonary Dysplasia.
Walkup LL, Woods JC. (2015). Clin Perinatol. 2015 Dec;42(4):871-87.

Quantification of neonatal lung parenchymal density via ultrashort echo time MRI with comparison to CT.
Higano NS, Fleck RJ, Spielberg DR, Walkup LL, Hahn AD, Thomen RP, Merhar SL, Kingma PS, Tkach JA, Fain SB, Woods JC. (2017). J Magn Reson Imaging. 2017 Oct;46(4):992-1000. 

Pulmonary MRI of neonates in the intensive care unit using 3D ultrashort echo time and a small footprint MRI system.
Hahn AD, Higano NS, Walkup LL, Thomen RP, Cao X, Merhar SL, Tkach JA, Woods JC, Fain SB. (2017). J Magn Reson Imaging. 2017 Feb;45(2):463-471.