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Disorders of the lungs and pleura are common in children and are a frequent indication for medical imaging. Over the past decade, a combination of advances in MR imaging scanner technology and increased concern about the effects of ionizing radiation has led to increased utilization of MR imaging in the pediatric population. Despite this general trend, there has been slower adoption of MR imaging to evaluate the lungs and pleura due to technical limitations including motion artifact, low signal-to-noise ratios, and signal dephasing at air-tissue interfaces. As MR imaging technology advances, many of these technical hurdles are being overcome, and MR imaging of the lungs and pleura has begun to be a feasible option for many pediatric pleuropulmonary conditions. Therefore, an up-to-date understanding of these emerging applications is important to practitioners performing MR imaging in infants and children. In this chapter, an overview of MR imaging techniques to evaluate the lungs and pleura in children is discussed. Normal anatomy and development of the lungs and pleura are described, and the MR imaging findings in a spectrum pediatric lung and pleural disease are illustrated.

Magnetic resonance imaging (MRI) has become a dominant imaging modality in the diagnosis and management of many pediatric diseases, largely motivated by a desire to avoid the harmful effects of ionizing radiation in children. Despite this general trend, technical factors have led MRI to be utilized less often for evaluation of diseases of the pediatric thorax compared with other organ systems. Technical advances in recent years have made MRI of the chest a feasible option, and MRI has become a first-line imaging modality for select disorders of pediatric thorax, including many cardiovascular and mediastinal lesions. With ongoing technical advances, MRI continues to have an increasing role in evaluation of diseases of the pediatric lung and airway. This chapter presents imaging techniques for MRI of the pediatric thorax followed by a description and illustration of MR imaging findings in a spectrum of disorders.