MRI of the upper airways in children and young adults: the MUSIC study.
RATIONALE
Paediatric laryngotracheal stenosis (LTS) is often successfully corrected with open airway surgery. However, respiratory and vocal sequelae frequently remain. Clinical care and surgical interventions could be improved with better understanding of these sequelae.


OBJECTIVE
The objective of this cross-sectional study was to develop an upper airway MRI protocol to obtain information on anatomical and functional sequelae post-LTS repair.


METHODS
Forty-eight patients (age 14.4 (range 7.5-30.7) years) and 11 healthy volunteers (15.9 (8.2-28.8) years) were included. Spirometry and static and dynamic upper airway MRI (3.0 T, 30 min protocol) were conducted. Analysis included assessment of postoperative anatomy and airway lumen measurements during static and dynamic (inspiration and phonation) acquisitions.


MAIN RESULTS
Good image quality without artefacts was achieved for static and dynamic images in the majority of MRIs. MRI showed vocal cord thickening in 80.9% of patients and compared with volunteers, a significant decrease in vocal cord lumen area (22.0 (IQR 17.7-30.3) mm2 vs 35.1 (21.2-54.7) mm2, p=0.03) but not cricoid lumen area (62.3±27.0 mm2 vs 66.2±34.8 mm2, p=0.70). Furthermore, 53.2% of patients had an A-frame deformation at site of previous tracheal cannula, showing lumen collapse during inspiration. Dynamic imaging showed incomplete vocal cord abduction during inspiration in 42.6% and incomplete adduction during phonation in 61.7% of patients.


CONCLUSIONS
Static and dynamic MRI is an excellent modality to non-invasively image anatomy, tissue characteristics and vocal cord dynamics of the upper airways. MRI-derived knowledge on postsurgical LTS sequelae might be used to improve surgery.
['Elders|Bernadette|B|', 'Ciet|Pierluigi|P|0000-0003-4017-8957', 'Tiddens|Harm|H|', 'van den Bosch|Wytse|W|', 'Wielopolski|Piotr|P|', 'Pullens|Bas|B|']
D000293:Adolescent D000328:Adult D002648:Child D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007829:Laryngostenosis D007830:Larynx D008279:Magnetic Resonance Imaging D008297:Male D014132:Trachea D014135:Tracheal Stenosis D014827:Vocal Cords D055815:Young Adult
imaging/CT MRI etc