{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:04:31Z","timestamp":1769634271598,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Flexible bronchoscopy (FOB) is the current gold standard for diagnosing tracheobronchomalacia (TBM). While dynamic magnetic resonance imaging (cine\u2010MRI) has emerged as a radiation\u2010free alternative for TBM diagnosis, a direct comparison of its diagnostic performance with FOB has not yet been performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the diagnostic performance of cine\u2010MRI versus FOB in detecting TBM and to assess the effect of bronchodilators on observed tracheobronchial collapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included 10 children (median age 11 years, range 8\u201317 years; five males) who were referred for suspected TBM. Cine\u2010MRI was performed using a 3 Tesla GE 750\u2009W scanner with specific sequences for static and dynamic imaging. Bronchodilator testing was conducted using 400\u2009\u00b5g salbutamol. Children suspected of TBM underwent both FOB and cine\u2010MRI. Cine\u2010MRI protocol included spirometry\u2010controlled static and dynamic sequences, pre\u2010 and post\u2010bronchodilator administration. FOB diagnoses were made by pediatric pulmonologists, and cine\u2010MRI assessments were independently evaluated by two trained observers, blinded to FOB results. Moreover, each child completed spirometry and a respiratory questionnaire. Descriptive statistics were used to summarize data. Diagnostic agreement and measurements repeatability were assessed using the intra\u2010class correlation coefficient (ICC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>FOB identified TBM in two children, whereas cine\u2010MRI detected TBM in four. In three of these four children TBM was not diagnosed by FOB. Notably, no TBM was observed during static pre\u2010bronchodilator cine\u2010MRI assessment, but two of the four children diagnosed with cine\u2010MRI met the diagnostic criteria of TBM only post\u2010bronchodilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cine\u2010MRI, particularly post\u2010bronchodilation shows a unique capability to detect TBM cases undetected by FOB. This may reflect its ability to perform dynamic functional measurements during active respiratory maneuvers, highlighting its potential as a valuable diagnostic tool for central airway disease in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71307","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T13:07:33Z","timestamp":1763125653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Central Airways Mechanics Using Dynamic Magnetic Resonance Imaging (Cine\u2010MRI): A Comparison to Flexible Bronchoscopy"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9234-5561","authenticated-orcid":false,"given":"Giulia","family":"Roberto","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo University of Pavia Pavia 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Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4291-468X","authenticated-orcid":false,"given":"Marielle","family":"Pijnenburg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Respiratory Medicine and Allergology Erasmus University Medical Centre \u2010 Sophia Children\u2032s Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8191-8598","authenticated-orcid":false,"given":"Daan","family":"Caudri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Respiratory Medicine and Allergology Erasmus University Medical Centre \u2010 Sophia Children\u2032s Hospital Rotterdam the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine Erasmus Medical Centre \u2010 Sophia Children\u2032s Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierluigi","family":"Ciet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\/Respiratory Medicine and Allergology Erasmus University Medical Centre \u2010 Sophia Children\u2032s Hospital Rotterdam the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine Erasmus Medical Centre \u2010 Sophia Children\u2032s Hospital Rotterdam the Netherlands"},{"name":"Department of Radiology, Policlinico Monserrato University of Cagliari Cagliari 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