Sleep cine magnetic resonance imaging—A dynamic evaluation of the airway

It has become more apparent in recent years that increasing numbers of children continue to have obstructive sleep apnea despite previous removal of the tonsils and adenoids. This occurs not only in children in “at-risk” populations, such as those with Down syndrome and obesity, but also in otherwise “normal” children. Sleep cine magnetic resonance imaging (MRI) provides a high-resolution examination of the airway during sleep without ionizing radiation exposure and allows for identification of site or sites of residual airway obstruction. This technique is particularly helpful since the diagnostic examination performed in awake adults for sleep apnea is not often possible in the pediatric population. The technique of sleep cine MRI and examples of its use are presented. Sample patient scenarios are used to illustrate how it can assist with treatment planning. Anesthesia use during the cine MRI is discussed.