Magnetic resonance imaging (MRI) has become an increasingly valuable modality for evaluating pediatric chest pathologies beyond cardiac disease. Its diagnostic spectrum now extends to mediastinal, pulmonary, pleural, and chest wall abnormalities. Although traditionally limited by long acquisition times, motion artefacts, and the challenges of lung parenchyma imaging, recent advances such as ultrashort echo time (UTE), and zero echo time (ZTE) sequences have markedly expanded its clinical utility. This educational poster highlights the applications of MRI across a broad range of pediatric thoracic conditions, including mediastinal masses, congenital lung malformations, pulmonary tumors, infections, inflammatory diseases, and chest wall abnormalities. The mediastinal pathologies are structured according to the standard compartmental classification - prevascular, visceral, and paravertebral - to facilitate a systematic and anatomical approach to interpretation. Drawing on our institutional experience of primary to quaternary referrals, we will present cases to: 1. Review key MRI techniques applicable to pediatric thoracic imaging, including diffusion-weighted and contrast-enhanced imaging, as well as motion-suppression strategies. 2. Demonstrate MRI findings for mediastinal, pulmonary and chest wall pathologies, focusing on lesion characterization and delineation of relationships to adjacent structures and provide pearls and pitfalls for confident interpretation. 3. Discuss the role of MRI in children, given their heightened tissue sensitivity and increased lifetime risk of radiation-induced malignancy. The advantage is even more significant in patients with cancer predisposition syndromes, in whom cumulative radiation exposure is a major concern. 4. Outline practical workflow aspects, including preparation techniques such as feed-and-sleep imaging and child-life involvement, as well as safety considerations for repeated or contrast-enhanced studies. 5. Compare MRI with CT and radiography, underscoring its diagnostic strengths, limitations, and complementary role in specific clinical scenarios. 6. Provide a structured overview and practical framework to support the use of chest MRI in pediatric imaging. This educational overview aims to familiarize radiologists with MRI’s current and evolving role in pediatric thoracic imaging, highlight achievable image quality and diagnostic confidence, and encourage broader clinical adoption of radiation-free chest MRI in children. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Schmidt Magdalena, Manson David, Zanette Brandon, Chiu Priscilla, Malkin David, Villani Anita, Greer Mary-louise

Keywords: Chest MRI, Lung Imaging, Mediastinum

Magnetic resonance imaging (MRI) is one of the essential diagnostic tools in pediatric radiology, however, obtaining high-quality, motion-free images in infants remains a challenge. Sedation or general anesthesia is often required to minimize motion artifacts, but these carry potential risks, including respiratory depression, prolonged recovery, and potential neurodevelopmental effects with repeated exposure. In addition, access to general anesthesia for MRI examinations is often limited, particularly in underdeveloped countries. The feed and wrap technique offers a safe, effective, and non-pharmacologic alternative to sedation for imaging infants, particularly those under 3 months of age. This educational poster will review the principles and practical steps of the feed and wrap technique, including patient selection, preparation, feeding strategies, swaddling methods, and optimization of MRI protocols. We will discuss environmental adjustments, such as room temperature control, noise reduction, and use of immobilization aids, to maximize success rates. In addition, we will present case examples demonstrating typical applications across brain, spine, and abdominal MRI studies, highlighting common pitfalls and troubleshooting strategies when motion or incomplete sequences occur. We will also compare diagnostic image quality between feed and wrap studies and sedated studies, review success rates reported in the literature, and provide practical guidance for implementing this technique in both community and tertiary care settings. Radiologists, technologists, and pediatricians play a key role in promoting safe, patient-centered imaging practices. Familiarity with the feed and wrap technique empowers pediatric imaging teams to reduce sedation rates, improve workflow efficiency and safety, while maintaining diagnostic quality in MRI examinations for the young patients. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Reyes Recasens Magdalena, Agarwal Nivedita, Alavi Mehvish, Gee Michael, Greer Mary-louise, Kim Hyun Gi, Kim Pyeong Hwa, Yoon Heemang, Jung Ah Young, Cho Young Ah, Lee Jin Seong, Tan Timothy Shao Ern, Atalabi Omolola Mojisola, Verhagen Martijn Vincent

Keywords: General Anesthesia, MRI Try Without Sedation, Safety