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Rapid lung MRI in children with pulmonary infections: Time to change our diagnostic algorithms
Kushaljit Singh Sodhi1, Niranjan Khandelwal1, Akshay Kumar Saxena1
1Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
Background:
To determine the diagnostic utility of a new rapid MRI protocol, as compared with computed tomography (CT) for the detection of various pulmonary and mediastinal abnormalities in children with suspected pulmonary infections.
Methods:
Seventy-five children (age range of 5 to 15 years) with clinically suspected pulmonary infections were enrolled in this prospective study, which was approved by the institutional ethics committee. All patients underwent thoracic MRI (1.5T) and CT (64 detector) scan within 48 h of each other. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI were evaluated with CT as a standard of reference. Inter-observer agreement was measured with the kappa coefficient.
Results:
MRI with a new rapid MRI protocol demonstrated sensitivity, specificity, PPV, and NPV of 100% for detecting pulmonary consolidation, nodules (>3 mm), cyst/cavity, hyperinflation, pleural effusion, and lymph nodes. The kappa-test showed almost perfect agreement between MRI and multidetector CT (MDCT) in detecting thoracic abnormalities (k = 0.9). No statistically significant difference was observed between MRI and MDCT for detecting thoracic abnormalities by the McNemar test (P = 0.125).
Conclusion:
Rapid lung MRI was found to be comparable to MDCT for detecting thoracic abnormalities in pediatric patients with clinically suspected pulmonary infections. It has a great potential as the first line cross-sectional imaging modality of choice in this patient population. However, further studies will be helpful for confirmation of our findings.
Insights
Rapid MRI is as effective as CT scans for diagnosing lung infections in children. This new MRI protocol shows high accuracy in detecting various thoracic abnormalities, offering a promising alternative imaging method.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Thoracic Imaging
Background:
- Assessing diagnostic utility of a novel rapid MRI protocol versus CT for pulmonary and mediastinal abnormalities in pediatric patients.
- Focus on children with suspected pulmonary infections.
Purpose of the Study:
- To compare the diagnostic performance of a new rapid MRI protocol against CT for detecting thoracic abnormalities in children.
- Evaluate MRI's sensitivity, specificity, PPV, and NPV using CT as the reference standard.
Main Methods:
- Prospective study of 75 children (5-15 years) with suspected pulmonary infections.
- All patients underwent both thoracic MRI (1.5T) and CT (64 detector) within 48 hours.
- Sensitivity, specificity, PPV, NPV, and inter-observer agreement (kappa coefficient) were calculated.
Main Results:
- Rapid MRI protocol achieved 100% sensitivity, specificity, PPV, and NPV for detecting consolidation, nodules, cysts, hyperinflation, effusions, and lymph nodes.
- Excellent agreement between MRI and multidetector CT (MDCT) for thoracic abnormalities (kappa = 0.9).
- No statistically significant difference in detection rates between MRI and MDCT (P = 0.125).
Conclusions:
- Rapid lung MRI is comparable to MDCT for diagnosing thoracic abnormalities in pediatric patients with suspected infections.
- This rapid MRI protocol shows potential as a primary cross-sectional imaging modality for this population.
- Further research is recommended to confirm these findings.
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