MRI for a 5-year-old child?

Question

Hello,
we have a 5-year-old child with CF.
Our child is doing very well. Up to now, no problematic germs have been detected and the lung function is also very good.
Now we have been told at the last visit of the CF center, that one would like to do in future an MRI with our child in order to detect possible changes of the lung early, if necessary also with mild anaesthesia.
Now I am a bit conflicted about that. On the one hand I have worries that this procedure could be too stressful to our child (lying 20 minutes calmly in a pipe) and we may by this jeopardize the until now relaxed visitis to the CF center. Also a possible anaesthesia causes me quite a headache. On the other hand, we as parents are interested in detecting possible changes of the lung early. Adult CF patients are only shaking their head if I am telling about the idea of our CF center. An MRI would be only in question for them if there would be any health problems.
But perhaps the early MRI is today an important part of the more advanced CF-therapy?
What is your opinion about this? Is it necessary to already perform at this age an MRI? The CF center says that the advantage of the MRI is that it has no radiation. Until now, an ultrasound had been done yearly. However, in the MRI one would see the changes of the lung more clearly.
Many thanks.

Answer

Dear family,
in contrast to x-ray or CT of the lung an MRI has no radiation, it generates images from the inner body via a strong magnetic field. However, the resolution of fine structures in the lung, especially in the air-filled areas of the very fine alveoli, is not very good, yet. In different CF-centers of the world there is intensiv research going on to optimize this radiation-free method of imaging of the lung and impressive success has already been achieved, which exceeds in some areas also the possibilities of the x-ray and CT.
Therefore, the MRI can become a method of the future and investigations of your child can contribute to gain new knowledge and probably this can already give hints for the therapy of your child.

In case no anaesthesia is necessary- e.g. after intensive preparation with lessons to lie calmly, what can already be successfull in a 5-year-old child- I would judge the project of your radiology department as uncritical.

Where appropriate, the mother or fahter can also go "in the MRI pipe", in order to calm down the child, so that no anaesthesia would be necessary.

In the end, taking part in the investigation program is voluntary and you have to decide about the investigation without having any disadvantages.

Yours sincerely,
PD Dr. Jochen Mainz

05.06.2013