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DOI: 10.1055/s-0028-1109128
© Georg Thieme Verlag KG Stuttgart · New York
Clinical Application of MRI in Children for the Assessment of Pulmonary Diseases
Klinische Anwendung von MRT zur Untersuchung von Lungenerkrankungen im KindesalterPublication History
received: 10.12.2008
accepted: 22.12.2008
Publication Date:
07 April 2009 (online)
![](https://www.thieme-connect.de/media/roefo/200905/lookinside/thumbnails/10.1055-s-0028-1109128-1.jpg)
Zusammenfassung
Das diagnostische Routineverfahren für pulmonale Erkrankungen bei Kindern ist die Röntgenübersichtsaufnahme. Dabei handelt es sich um eine schnell durchzuführende und kostengünstige Untersuchung, die einen guten Überblick über die Anatomie und Pathologien zeigt. Bei Patienten mit unklaren Befunden oder wo eine detaillierte Darstellung der Anatomie nötig ist, z. B. vor Interventionen, wird meistens eine Computertomografie durchgeführt. Dieses Verfahren besitzt zwar eine sehr gute Ortsauflösung, aber nur einen schlechten Weichteilkontrast und zudem ist die applizierte Röntgenstrahlung nicht zu unterschätzen. Aktuell steht mit der Magnet-Resonanz-Tomografie (MRT) ein Verfahren zur Verfügung, mit dem sich ebenfalls schnell und zuverlässig Lungenerkrankungen diagnostizieren lassen. Aufgrund des hohen Weichteilkontrasts kann die Diagnose oftmals ohne Kontrastmittelapplikation gestellt werden. Diese Übersichtsarbeit stellt das Routine-Protokoll unserer Klinik vor. Die Anwendung und Ergebnisse wird bei Patienten mit infektiösen Erkrankungen, Patienten mit Immunschwächen, anatomischen Abnormalitäten, erworbenen chronischen Lungenkrankungen und pulmonalen Tumoren demonstriert. Da die MRT vor allem für funktionelle Untersuchungen gut geeignet ist, wird ein Untersuchungsprotokoll für Thoraxdeformitäten vorgestellt. Diese Übersichtsarbeit demonstriert der Einsatz der Lungen-MRT in der klinischen pädiatrischen Routine mit speziellem Bezug zu klinischen Indikationen als strahlenfreie Methode.
Abstract
The standard examination technique for the chest in children is an X-ray examination – it is fast, cheap and provides a good overview of anatomy and pathology. In cases with an unclear pathology or if more details are needed (i. e. pre-therapeutically), computed tomography is most often performed with the well known drawbacks of limited soft tissue contrast and radiation. Radiation should be avoided in children, especially if follow-up examinations are needed. Recent magnetic resonance (MR) techniques allow for fast and reliable assessment of pulmonary diseases in children. Due to the inherent soft tissue contrast, diagnosis can be frequently performed without contrast media application. This review provides an exemplary MR examination protocol for routine application in pediatric patients. The diagnostic value of MRI is shown in patients with infectious diseases, patients with immunodeficiency, anatomic abnormalities, acquired chronic diseases, and pulmonary tumors. Since MRI is especially suitable for functional imaging, an MR protocol is provided for the examination of thoracic deformities. This review summarizes the use of thoracic MRI in the clinical pediatric setting with special focus on the clinical indications as a radiation-free method.
Key words
Pediatric - Lung - thorax - MR imaging - MR perfusion
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Dr. Sebastian Ley
Diagnostische und Interventionelle Radiologie, Universitätsklinik Heidelberg
Im Neuenheimer Feld 430
69120 Heidelberg
Germany
Phone: + + 49/62 21/5 63 82 78
Fax: + + 49/62 21/5 62 998
Email: ley@gmx.de