MR imaging in infants with airway obstruction: preliminary observations

Magnetic resonance (MR) imaging of the trachea and main bronchi was performed in seven infants (aged 3-15 months) with symptoms of airway obstruction. Diagnoses made clinically, radiologically, and by transnasal flexible fiberoptic endoscopy included vascular ring (one patient), tracheal compression by the innominate artery (five patients), and tracheomalacia (one patient). MR images in sagittal and axial sections clearly demonstrated tracheal compression at the level of the innominate artery in three infants and tracheal narrowing due to a vascular ring in one patient. The other three patients had airway narrowing apparently unrelated to aberrant vascular structures on MR images. The appearance of the airways on MR images corresponded closely to endoscopic observations. It is concluded that MR imaging is capable of demonstrating airway obstruction in infants and delineating any relationship to major mediastinal blood vessels.