The first experience of using magnetic resonance tomography for lung imaging in children with cystic fibrosis: opportunities and prospects

Abstract

Cystic fibrosis (CF) is a hereditary disease associated with systemic failure of the exocrine glands. In 95% of the cases, progressive damage to the lung tissue occurs that requires follow-up. The main imaging methods are radiography and computed tomography (CT). Both methods involve ionizing radiation. According to clinical guidelines, a chest X-ray is performed no more than once every 2 years. However, given the high risk of developing inflammatory processes in children with CF, the frequency of radiological examinations may increase significantly. The search for alternative methods without ionizing radiation is in great demand among children with CF. One of these methods is magnetic resonance imaging (MRI).The aim was to explore the capabilities of MRI for imaging lung tissue in children with CF.Methods. The study included 12 patients aged 7 to 18 years with newly diagnosed and previously diagnosed CF. All children underwent CT and MRI of the chest.Results. In all children (100%), chest CT revealed a complex of changes typical of CF: signs of chronic bronchitis, widespread saccular and cylindrical bronchiectasis of various localizations, areas of pulmonary fibrosis, infiltrative changes in the lung tissue. Chest MRI is most effective (100%) in identifying areas of pulmonary fibrosis (thickening of the lung tissue), accumulation of exudate in the lumen of bronchiectasis, and infiltrative changes. In contrast to CT, MRI is less effective in the assessment of bronchitis changes with thickening of the bronchial walls without exudate (83%). A low efficiency of MRI is observed in the visualization of bronchiectasis with a free lumen (without signs of mucostasis).Conclusion. Radiography and computed tomography remain the main methods for lung imaging in children with CF. However, taking into account the absence of ionizing radiation, the development of the method and the emergence of new sequences, chest MRI can be used effectively for follow-up instead of radiography and CT, reducing the radiation dose received.