Promising Role of Ultrashort Time Echo MRI in Evaluating Lung Abnormalities in Pediatric Febrile Neutropenia

Magnetic resonance imaging (MRI) of lungs in children has shown significant potential and efficacy comparable to CT scans for identifying various thoracic conditions without the risk of radiation exposure. A recent advancement, the ultrashort time echo (UTE) sequence, enhances the optimal analysis of lung parenchyma and produces images similar to those from computed tomography (CT) scans. This sequence is particularly effective for visualizing structures with short T2* properties, such as lung parenchyma, which are sub-optimally visualized by traditional MRI techniques. In the current preliminary study, the researchers assessed the effectiveness of the UTE sequence as a radiation-free method for identifying lung abnormalities in children with febrile neutropenia. 

The results demonstrated:

• The study included ten children aged 5 to 14, who underwent both CT and MRI (including UTE and conventional sequences like T2-TSE and T2 MultiVane XD).
• They evaluated the imaging results for ground-glass opacities (GGOs), consolidation, nodules, and pleural effusion, using CT as the reference standard.
• The UTE sequence demonstrated 100% sensitivity in detecting GGOs (4 cases), consolidation (3 cases), nodules (4 cases), and pleural effusion (3 cases).
• The T2-TSE and MVXD sequences also showed 100% sensitivity for consolidation, nodules, and pleural effusion, but detected GGOs with 75% sensitivity due to one missed case.

Thus, the study concluded that the UTE MRI sequence has a higher sensitivity for identifying GGOs and has comparable sensitivity and specificity for detecting consolidation, lung nodules, and pleural effusion when compared to CT and other MRI sequences. Given that pulmonary parenchymal changes, including GGOs, are common in children with febrile neutropenia, UTE MRI presents a potent diagnostic tool for evaluating these changes in children.

Source: Bhatia, A., Rana, P., Mathew, J.L. et al. Ultrashort Time Echo (UTE) MR Sequence - New MRI Sequence with CT Alike Images as a Radiation-Free Alternative to CT in Children with Febrile Neutropenia. Indian J Pediatr. 2024. https://doi.org/10.1007/s12098-024-05379-5