LAUSR

Background: Lung MRI is a promising tool to monitor early functional and structural changes in cystic fibrosis (CF) lung disease. MRI in preschool children is challenging due to motion artefacts and patient anxiety. For appropriate diagnostic quality often sedation is required. This limits routine application. Aim: To assess the feasibility of a lung MRI protocol in unsedated preschool children with CF in comparison to lung function. Methods: Children with CF at 4 and 6 years of age were enrolled for lung function testing and MRI, with a preparation program. The non-invasive MRI protocol consisted of functional free-breathing and morphological sequences. Functional data were used to calculate relative perfusion and ventilation with Matrix Pencil-MRI as previously described. Feasibility was compared to spirometry and N2-multiple breath washout (MBW). Results: Twenty-one children were recruited at 4 years (mean (SD): 4.2y (0.4)) and 41 at 6 years (6.6y (0.6)). Overall feasibility was 76% for MRI, 87% for MBW and 84% for spirometry. In 4-year-old children, feasibility was 38% for MRI, 81% for MBW and 86% for spirometry. In the 6-year-olds, feasibility was 95% for MRI, 90% for MBW and 83% for spirometry. From all children with unsuccessful MRI’s, two-third stopped the procedure prior to lying in the scanner due to anxiety. All children who finished the MRI protocol achieved sufficient diagnostic image quality. Mean scan duration was 25 minutes. 55% of children had a perfusion impairment and 11% had a ventilation impairment. Conclusion: Unsedated lung MRI is feasible in preschoolers but clearly depends on age and patient anxiety. Successful scans resulted in good diagnostic image quality.