A recent study illustrated that the use of longitudinal paranasal sinus magnetic resonance imaging (MRI) is beneficial for the detection of onset and advancement of chronic rhinosinusitis (CRS) from infancy to school age in children with cystic fibrosis. Researchers sought to longitudinally assess CRS in cystic fibrosis using MRI from infancy to school age. A total of 64 cystic fibrosis kids (mean age at baseline 1.1 ± 1.6 years, range 0-5 years) experienced a mean of 5.8 ± 2.2 (range 3 to 11) annual MRI exams.

Before and at least 2 months after commencing lumacaftor/ivacaftor, 24 additional kids (9.2±4.4 years old, range 3–17 years) homozygous for the F508del mutation received MRIs. The previously measured CRS-MRI score was used to evaluate the MRI. The majority of paranasal sinuses (65-87%) were opaque during infancy, and mucosal edema predominated (58-97%). At preschool age (1–5 years), mucosal edema was the most prevalent anomaly (79–94%, P<0.05), and 79–94% of the sinuses were opacified (P<0.05 compared to infancy).

At school age (age >6 years), mucopyoceles were the predominant anomaly in the maxillary and frontal sinuses (53-56%, P<0.05-0.808), and nearly all sinuses were opacified (71-99%, P<0.001-0.357 compared to preschool age). From 22.4 ±9.6 in infancy to 34.2±9.6 in preschool age and 34.0 ±5.7 in school age, the CRS-MRI sum score elevated. The CRS-MRI sum score (-0.5 ± 3.3) and maxillary sinus subscore (-0.5 ± 1.5) in children receiving lumacaftor/ivacaftor therapy improved.

In kids having cystic fibrosis, longitudinal MRI shows an early beginning, development of severity of CRS from infancy to school age, and responsiveness to lumacaftor/ivacaftor. These findings suggest its use for thorough, non-invasive CRS monitoring in cystic fibrosis children.