Virtual Bronchoscopy of Neonatal Airway Malacia via High-Resolution, Respiratory-gated Magnetic Resonance Imaging

Higano, Nara S.; Gandhi, Deep; Xiao, Qiwei; Gunatilaka, C.C.; Hysinger, Erik B.; Fleck, Robert; Woods, Jason C.; Bates, Alister J.

doi:10.1164/rccm.202202-0362im

Cited by 3 publications

(2 citation statements)

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“…UTE MRI has recently been validated and correlated with flexible bronchoscopy in infants with TBM and demonstrates great potential in evaluating central airways while decreasing exposure to potential radiation in infants 46 . Recent studies evaluating neonatal airways by use of UTE MRI continue to be developed, though widespread use of this imaging technique may be limited by center availability in addition to the technical challenges of completing an MRI quickly in an awake mechanically ventilated infant 47,48 . Dynamic CT is a noninvasive technique of increasing utility in infants that require sensitive analysis 45 .…”

Section: Discussionmentioning

confidence: 99%

“…46 Recent studies evaluating neonatal airways by use of UTE MRI continue to be developed, though widespread use of this imaging technique may be limited by center availability in addition to the technical challenges of completing an MRI quickly in an awake mechanically ventilated infant. 47,48 Dynamic CT is a noninvasive technique of increasing utility in infants that require sensitive analysis. 45 By using a short, quantifiable, low radiation technique, this may be adapted to referral centers where bronchoscopy and UTE MRI are limited or unavailable.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia

Pugh,

Ali,

Agarwal

et al. 2023

Pediatric Pulmonology

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IntroductionDynamic computed tomography (dCT) gives real‐time physiological information and objective descriptions of airway narrowing in tracheobronchomalacia (TBM). There is a paucity of literature in the evaluation of TBM by dCT in premature infants with bronchopulmonary dysplasia (BPD). The aim of this study is to describe the findings of dCT and resultant changes in management in premature infants with TBM.MethodsA retrospective study of 70 infants was performed. Infants included were <32 weeks gestation without major anomalies. TBM was defined as ≥50% expiratory reduction in cross‐sectional area with severity defined as mild (50%–75%), moderate (≥75%–90%), or severe (≥90%).ResultsDynamic CT diagnosed malacia in 53% of infants. Tracheomalacia was identified in 49% of infants with severity as 76% mild, 18% moderate, and 6% severe. Bronchomalacia was identified in 43% of infants with varying severity (53% mild, 40% moderate, 7% severe). Resultant management changes included PEEP titration (44%), initiation of bethanechol (23%), planned tracheostomy (20%), extubation trial (13%), and inhaled ipratropium bromide (7%).ConclusionDynamic CT is a useful noninvasive diagnostic tool for airway evaluation of premature infants. Presence and severity of TBM can provide actionable information to guide more precise clinical decision making.

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Section: Discussionmentioning

confidence: 99%