Clinical Report: Neonatal Chest MRI Feasibility for Bronchopulmonary Dysplasia Using 1.5-T Scanner

Overview

This pilot study demonstrates the feasibility of using a standard 1.5-Tesla MRI scanner with a dedicated neonatal chest coil to image lung structure in neonates with severe bronchopulmonary dysplasia (BPD). The developed MRI protocol enables qualitative and quantitative assessment of BPD-related lung abnormalities without sedation, potentially supporting improved phenotyping and personalized treatment strategies.

Background

Bronchopulmonary dysplasia is the most common chronic lung disease in preterm infants, characterized by disrupted alveolar and vascular development leading to structural lung abnormalities. Current BPD severity classification relies on oxygen dependency at 36 weeks postmenstrual age, but imaging methods to assess lung structure in neonates are limited. MRI offers a radiation-free alternative to CT and allows dynamic imaging of lung function, but prior neonatal studies used specialized MRI systems not widely available. This study aimed to develop and evaluate a reproducible chest MRI protocol for neonates with BPD using a conventional 1.5-T MRI system.

Data Highlights

Key Findings

• The neonatal chest MRI protocol using a standard 1.5-T scanner and dedicated coil was successfully implemented without sedation using a feed-and-swaddle technique.
• Qualitative image assessment showed acceptable image quality with manageable artefacts across sequences.
• Quantitative analysis using the MERGE scoring system enabled identification and volumetric assessment of BPD-related lung abnormalities, including hypointense regions and bronchopathy.
• The MRI protocol allowed differentiation between normal lung tissue and various structural abnormalities relevant to BPD phenotyping.
• Chest CT scans performed at 6 months corrected age provided complementary structural information for clinical correlation.

Clinical Implications

This study supports the use of standard 1.5-T MRI systems with dedicated neonatal coils for non-invasive, radiation-free imaging of lung structure in neonates with severe BPD. The protocol facilitates detailed phenotyping of lung abnormalities, which may guide personalized treatment and prognosis. Implementing this MRI approach in clinical practice could improve monitoring and management of BPD without the risks associated with sedation or ionizing radiation.

Conclusion

The developed neonatal chest MRI protocol on a standard 1.5-T scanner is feasible and effective for assessing structural lung abnormalities in severe BPD. This approach holds promise for enhancing clinical phenotyping and guiding individualized care in this vulnerable population.

References

1. Bae et al 2019 -- MRI Image Quality Assessment Method
2. PRAGMA-BPD and MERGE Scoring System Studies 2017-2022
3. VINyL Study Protocol and Prior Work 2021-2023