Abstract
The acceptance of applications for the use of chest MRI in children has been somewhat slow and selective. The use of MRI to image chest wall lesions is likely the most common and widely used indication, aside from the widespread and somewhat sophisticated use of MRI in imaging the cardiovascular structures of the chest. In this respect, fairly standard variations of T1-W, T2-W and contrast-enhanced imaging can be used, similar to the sequences used for musculoskeletal lesions elsewhere in the body. Imaging of the anterior mediastinal masses should be performed in conjunction with a detailed pre-test clinical examination to determine potential cardiovascular compromise. MRI in the setting of middle mediastinal adenopathy, congenital mediastinal cysts or posterior mediastinal masses, however, has been shown to be more effective and more comprehensive than multidetector CT. Although sonographic imaging is the initial modality of choice for pleural abnormalities, MR imaging is extremely effective and clinically useful in the setting of a potentially ambiguous sonographic examination. Faster imaging protocols are likely to increase the acceptance of MRI to replace multidetector CT for many pediatric chest lesions.
Similar content being viewed by others
References
Siegel MJ, Nadel SN, Glazer HS et al (1986) Mediastinal lesions in children: comparison of CT and MR. Radiology 160:241–244
Coley BD (2005) Pediatric chest ultrasound. Radiol Clin North Am 43:405–418
Takahashi K, Al-Janabi NJ (2010) Computed tomography and magnetic resonance imaging of mediastinal tumors. Magn Reson Imaging 32:1325–1339
Franco A, Mody NS, Meza M (2005) Imaging evaluation of pediatric mediastinal masses. Radiol Clin North Am 43:325
Newman B (2011) Thoracic neoplasms in children. Radiol Clin North Am 49:633–664
Frush DP (2002) Imaging evaluation of the thymus and thymic disorders in children. In: Lucaya J, Strife J (eds) Pediatric chest imaging: chest imaging in infants and children. Springer, Berlin Heidelberg, p 187
Wright CD (2009) Mediastinal tumors and cysts in the pediatric population. Thorac Surg Clin 19:47–61
Ackman B (2015) MR imaging of mediastinal masses. Magn Reson Imaging Clin N Am 23:141–164
McHugh K (2002) Chest tumours other than lymphoma. In: Lucaya J, Strife J (eds) Pediatric chest imaging: chest imaging in infants and children. Springer, Berlin Heidelberg, pp 263–287
Randall PA, Trasolini NC, Kohman LJ et al (1993) MR imaging in the evaluation of the chest after uncomplicated median sternotomy. Radiographics 13:329–340
Van Rijn RR, Berger RM, Lequin MH et al (2002) Development of a perigraft seroma around modified Blalock-Taussig shunts: imaging evaluation. AJR Am J Roentgenol 178:629–633
Mandell GA, Lantieri R, Goodman LR (1982) Tracheobronchial compression in Hodgkin lymphoma in children. AJR Am J Roentgenol 139:1167–1170
Azizkhan RG, Dudgeon DL, Buck JR et al (1985) Life-threatening airway obstruction as a complication to the management of mediastinal masses in children. J Pediatr Surg 20:816–822
Hammer GB (2004) Anaesthetic management for the child with a mediastinal mass. Paediatr Anaesth 14:95–97
Perger L, Lee E, Shamberger RC (2008) Management of children and adolescents with a critical airway due to compression by an anterior mediastinal mass. J Pediatr Surg 43:1990–1997
Siegel MJ, Luker GD (1996) Pediatric chest MR imaging. Noncardiac clinical uses. Magn Reson Imaging Clin N Am 4:599–613
Williams HJ, Alton HM (2005) Imaging of paediatric mediastinal abnormalities. Paediatr Respir Rev 4:55–66
Peprah KO, Andronikou S, Goussard P (2012) Characteristic magnetic resonance imaging low T2 signal intensity of necrotic lung parenchyma in children with pulmonary tuberculosis. J Thorac Imaging 27:171–174
Moon WK, Im JG, Yu IK et al (1996) Mediastinal tuberculous lymphadenitis: MR imaging appearance with clinicopathologic correlation. AJR Am J Roentgenol 166:21–25
Abdel Razek AA, Elkammary S, Elmorsy AS et al (2011) Characterization of mediastinal lymphadenopathy with diffusion-weighted imaging. Magn Reson Imaging 29:167–172
Biederer J, Hintze C, Fabel M (2008) MRI of pulmonary nodule: technique and diagnostic value. Cancer Imaging 8:125–130
Lee EY, Dorkin H, Vargas SO (2011) Congenital pulmonary malformations in pediatric patients: review and update on etiology, classification, and imaging findings. Radiol Clin North Am 49:921–948
Slovis TL, Meza MP, Cushing et al (1997) Thoracic neuroblastoma: what is the best imaging modality for the evaluation for extent of disease? Pediatr Radiol 27:273–275
Jaggers J, Balsara K (2004) Mediastinal masses in children. Semin Thorac Cardiovasc Surg 16:201–208
Monclair T, Mosseri V, Cecchetto G et al (2015) Influence of image-defined risk factors on the outcome of patients with localised neuroblastoma. A report from the LNESG1 study of the European International Society of Paediatric Oncology Neuroblastoma Group. Pediatr Blood Cancer 62:1536–1542
Lee EY, Boiselle PM, Cleveland RH (2008) Multi detector CT of congenital lung anomalies. Radiology 247:632–648
Bush A (2001) Congenital lung disease: a plea for clear thinking and clear nomenclature. Pediatr Pulmonol 32:328–337
Lee EY, Siegel MJ, Sierra LM et al (2004) Evaluation of angio-architecture of pulmonary sequestration in pediatric patients using 3D MDCT angiography. AJR Am J Roentgenol 183:183–188
Bissett GS 3rd (1996) MR imaging of soft-tissue masses in children. Magn Reson Imaging Clin N Am 4:697–719
Eich G, Kellenberger C, Willi U (2002) Radiology of the chest wall. In: Lucaya J, Strife J (eds) Pediatric chest imaging: chest imaging in infants and children. Springer, Berlin Heidelberg, pp 1–26
Golladay ES, Hale JA, Mollitt DL et al (1985) Chest wall masses in children. South Med J 78:292–295
Watt AJ (2002) Chest wall lesions. Paediatr Respir Rev 3:328–338
Harty M, Kramer SS (1998) Recent advances in pediatric pulmonary imaging. Curr Opin Pediatr 10:227–235
Garzon M (2000) Hemangiomas: update on classification, clinical presentation and associated anomalies. Cutis 66:325–328
Glasson MJ, Taylor SF (1991) Cervical, cervicomediastinal and intrathoracic lymphangioma. Prog Paediatr Surg 27:62–83
Karmazyn B, Davis MM, Davey MS et al (1998) Imaging evaluation of chest wall tumors in children. Acad Radiol 5:642–654
Donnelly L, Frush D (1999) Abnormalities of the chest wall in pediatric patients. AJR Am J Roentgenol 173:1595–1601
Donnelly LF, Taylor CNR, Emery KH et al (1997) Asymptomatic palpable anterior chest wall lesions in children: is cross-sectional imaging necessary? Radiology 202:829–831
Marcovici PA, LoSasso BE, Kruk P et al (2011) MRI for the evaluation of pectus excavatum. Pediatr Radiol 41:757–758
Lo Piccolo R, Bongini U, Basile M et al (2012) Chest fast MRI: an imaging alternative on pre-operative evaluation of pectus excavatum. J Pediatr Surg 47:485–489
Danner-Koptik K, Kletzel M, Dilley KJ (2013) Exostoses as a long-term sequela after pediatric hematopoietic progenitor cell transplantation: potential causes and increase risk of secondary malignancies from Ann & Robert H. Lurie Children’s Hospital of Chicago [sic]. Biol Blood Marrow Transplant 19:1267–1270
Paulino AC, Fowler BZ (2005) Secondary neoplasms after radiotherapy for a childhood solid tumor. Pediatr Hematol Oncol 22:89–101
Shamberger RC, Grier HE (1994) Chest wall tumors in infants and children. Semin Pediatr Surg 3:267–276
Anupindi SA, Bedoya MA, Lindell RB et al (2015) Diagnostic performance of whole-body MRI as a tool for cancer screening in children with genetic cancer-predisposing conditions. AJR Am J Roentgenol 205:400–408
Fritz J, Tzaribatchev N, Claussen CD et al (2009) Chronic recurrent multifocal osteomyelitis: comparison of whole-body MR imaging with radiography and correlation with clinical and laboratory data. Radiology 252:842–851
Jurik AG, Egund N (1997) MRI in chronic recurrent multifocal osteomyelitis. Skeletal Radiol 26:230–238
Balamuth N, Womer RB (2010) Ewing’s sarcoma. Lancet Oncol 11:184–192
Crisci KL, Greenberg SB, Wolfson B (1997) Cardiopulmonary and thoracic tumors of childhood. Radiol Clinics North Am 35:1341–1366
Meyer JS, Nadel HR, Marina N (2008) Imaging guidelines for children with Ewing sarcoma and osteosarcoma: a report from the Children’s Oncology Group Bone Tumor Committee. Pediatr Blood Cancer 51:163–170
Carter BW, Gladish GW (2015) MR imaging of chest wall tumors. Magn Reson Imaging Clin N Am 23:197–215
Navarro OM (2009) Imaging of benign pediatric soft tissue tumors. Semin Musculoskelet Radiol 13:196–209
Stein-Wexler R (2009) MR imaging of soft tissue masses in children. Magn Reson Imaging Clin N Am 17:489–507
Compeyrot-Lacassagne S, Feldman BM (2005) Inflammatory myopathies in children. Pediatr Clin North Am 52:493–520
Walker UA (2008) Imaging tools for the clinical assessment of idiopathic inflammatory myositis. Curr Opin Rheumatol 20:656–661
Devaney D, Livesley P, Shaw D (1995) Elastofibroma dorsi: MRI diagnosis in a young girl. Pediatr Radiol 25:282–283
Tamimi Mariño I, Sesma Solis P, Pérez Lara A et al (2013) Sensitivity and positive predictive value of magnetic resonance imaging in the diagnosis of elastofibroma dorsi: review of fourteen cases. J Shoulder Elbow Surg 22:57–63
Bhargava R, Parham DM, Lasater OE et al (1997) MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol 27:124–129
Serletis D, Parkin P, Bouffet E et al (2007) Massive plexiform neurofibromas in children: natural history and management issues. J Neurosurg 106:363–367
Cohen M (1992) Imaging of children with cancer. Mosby-Yearbook, St. Louis
Yikilmaz A, Koc A, Coskun A et al (2011) Evaluation of pneumonia in children: comparison of MRI with fast imaging sequences at 1.5T with chest radiographs. Acta Radiol 52:914–919
Stein R, Manson D (2012) Magnetic resonance imaging findings of empyema necessitans in a child with a group A streptococcus infection. J Thorac Imaging 27:W13–W14
Peltola V, Ruuskanen O, Svedström E (2008) Magnetic resonance imaging of lung infections in children. Pediatr Radiol 38:1225–1231
Kuhn JP (2004) Pleura. In: Kuhn JP, Slovis TL, Haller JO (eds) Caffey’s pediatric diagnostic imaging, 10th edn, section IV, part VI. Elsevier, Philadelphia, pp 867–890
Inan N, Arslan A, Akansel G et al (2009) Diffusion-weighted MRI in the characterization of pleural effusions. Diagn Interv Radiol 15:13–18
Suut S, Al-Ani Z, Allen C et al (2015) Pictorial essay of radiological features of benign intrathoracic masses. Ann Thorac Med 10:231–242
Dehner LP, Tazelaar HD, Manabe T (2004) Pleuropulmonary blastoma. Pathology and genetics of tumors of the lung, pleura, thymus and heart. In: WHO organization classification of tumors. IARC Press, Lyon, pp 99–100
Oliveira C, Himidan S, Pastor AC et al (2011) Discriminating preoperative features of pleuropulmonary blastomas (PPB) from congenital cystic adenomatoid malformations (CCAM): a retrospective, age-matched study. Eur J Pediatr Surg 21:2–7
Gill RR, Patz S, Muradyan I et al (2015) Novel MR imaging applications for pleural evaluation. Magn Reson Imaging Clin N Am 23:179–195
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors have no financial interests, investigational or off-label uses to disclose.
Rights and permissions
About this article
Cite this article
Manson, D.E. Magnetic resonance imaging of the mediastinum, chest wall and pleura in children. Pediatr Radiol 46, 902–915 (2016). https://doi.org/10.1007/s00247-016-3598-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-016-3598-7