Pulmonary Disease Clinical Trial
Official title:
Thoracic Imaging in Children With Neither Irradiation Nor Injection, by a New MRI Protocol Including Advanced Zero Time Echo (ZTE)
The aim of this study is to compare a new Magnetic Resonance Imaging (MRI)protocol, including a new MRI sequence for visualization of lung parenchyma, to computed tomography as the gold standard for the evaluation of thoracic region in children.
The potential effects of ionizing radiation are of particular concern in children. Exposure
to ionizing radiation of medical origin is responsible for an increased risk of brain tumors
and hematopoietic lineage in children. It is therefore necessary to find alternative to the
use of irradiating imaging examinations. Currently, computed tomography (CT) is the gold
standard in the study of lung diseases and is used in children deepening of standard
radiography in acute or chronic situations, sometimes requiring iterative controls. Chest CT
delivers a radiation dose equivalent to up to 500 days of natural exposure. Moreover, for the
analysis of mediastinal and vascular structures it requires an intravenous injection of
iodinated contrast, potentially source of nephrotoxicity and anaphylactic reactions.
Recently, new developments in Magnetic Resonance Imaging (MRI) have shown interest in the
study of lung diseases when they are responsible for filling of aeric structures (mucoid
impaction in cystic fibrosis, alveolar filling in infectious process and tumor) and in the
analysis of vascular and mediastinal structures and heart. However, the aerated lung
presenting a very low density of protons, and MRI being particularly sensitive to artifacts
from cardiac and respiratory movements, sequences currently used in MRI remain insufficient
in the analysis of pulmonary structures and pathologic conditions not filling aeric spaces
(bronchial, cystic, emphysematous or interstitial diseases). The aim of this study is to test
in clinical practice, a new MRI sequence for visualizing lung parenchyma, 3D zero Time Echo
(Advanced ZTE) and to propose a protocol combining several MRI sequences without injection as
an alternative to chest CT with or without contrast medium injection in childhood.
The proposed hypotheses are :
1. MRI sequence Advanced ZTE allows visualization of normal and pathological lung
parenchymal structures.
2. A complete MRI protocol, without injection, including this sequence to those already
used in clinical practice could replace the enhanced CT in most pediatric indications.
The principal objective of the study is to evaluate the Advanced ZTE sequence in the
visualization of lung parenchyma structures in comparison to CT scan in lung window as gold
standard.
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