Real-time, cine magnetic resonance imaging for evaluation of the pediatricairway

Background: Standard magnetic resonance imaging (MRI) and computed tomograp hic (CT) modalities are limited in their ability to image dynamic organs. N ew real-time, dynamic, cine magnetic resonance imaging (CMRI) techniques ha ve the potential to image moving structures. Objective: We therefore invest igated the feasibility of using CMRI techniques to dynamically image the hu man airway, to assess laryngeal and tracheal patency and function. Methods: A cohort of 10 pediatric patients, 10 adult patients, and 10 normal volunt eers underwent routine static MRI, as well as CMRI using a Siemens 1.5 T Vi sion system (Siemens, Erlangen, Germany). Patients also underwent endoscopi c evaluation. Cine axial, coronal, and sagittal sequences of the larynx and trachea were obtained during quiet respiration, as well as during a variet y of provocative maneuvers. Results. CMRI readily demonstrated normal vocal cord mobility and tracheal stability in normal volunteers. Abnormal vocal mobility was easily appreciated using the CMRI imaging system. Similarly, d ynamic effects of tracheomalacia were clearly demonstrated using CMRI. Dyna mic extrinsic tracheal compression resulting from mass lesions or anomalous vasculature was also visualized using CMRI. Conclusions: Cine MRI of the a irway has the potential to provide novel data regarding laryngeal and trach eal patency and function. This evolving modality may serve as a valuable ad junct to static MR and CT imaging, as well as endoscopy, in the assessment of the airway.