Received: 18 July 2018 | Accepted: 15 December 2018 DOI: 10.1002/ppul.24250 REVIEW Magnetic resonance imaging of the larynx in the pediatric population: A systematic review Bernadette B. L. J. Elders MD 1,2 | Sergei M. Hermelijn MD 1 | Harm A. W. M. Tiddens MD, PhD 1,2 | Bas Pullens MD, PhD 3 | Pjotr A. Wielopolski 2 | Pierluigi Ciet MD, PhD 1,2 1 Department of Paediatric Pulmonology, Erasmus Medical Centre—Sophia Children's Hospital, Rotterdam, The Netherlands 2 Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands 3 Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre—Sophia Children's Hospital, Rotterdam, The Netherlands Correspondence Harm A. W. M. Tiddens, MD, PhD, Department of Paediatric Pulmonology, Erasmus Medical Centre—Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands. Email: h.tiddens@erasmusmc.nl Abstract Background: Magnetic Resonance Imaging (MRI) techniques to image the larynx have evolved rapidly into a promising and safe imaging modality, without need for sedation or ionizing radiation. MRI is therefore of great interest to image pediatric laryngeal diseases. Our aim was to review MRI developments relevant for the pediatric larynx and to discuss future imaging options. Methods: A systematic search was conducted to identify all morphological and diagnostic studies in which MRI was used to image the pediatric larynx, laryngeal disease, or vocal cords. Results: Fourteen articles were included: three studies on anatomical imaging of the larynx, two studies on Diffusion Weighted Imaging, four studies on vocal cord imaging and five studies on the effect of anaesthesiology on the pediatric larynx. MRI has been used for pediatric laryngeal imaging since 1991. MRI provides excellent soft tissue contrast and good visualization of vascular diseases such as haemangiomas. However, visualization of cartilaginous structures, with varying ossification during childhood, and tissue differentiation remain challenging. The latter has been partly overcome with diffusion weighted imaging (DWI), differentiating between benign and malignant masses with excellent sensitivity (94-94.4%) and specificity (91.2-100%). Vocal cord imaging evolved from static images focused on vocal tract growth to dynamic images able to detect abnormal vocal cord movement. Conclusion: MRI is promising to evaluate the pediatric larynx, but studies using MRI as diagnostic imaging modality are scarce. New static and dynamic MR imaging techniques could be implemented in the pediatric population. Further research on imaging of pediatric laryngeal diseases should be conducted. KEYWORDS imaging, larynx, magnetic resonance imaging, pediatric This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2019 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc. 478 | wileyonlinelibrary.com/journal/ppul Pediatric Pulmonology. 2019;54:478–486.