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AJNR Am J Neuroradiol. 2016 Jan;37(1):11-8. doi: 10.3174/ajnr.A4464. Epub 2015 Sep 17.

Minimizing Radiation Exposure in Evaluation of Pediatric Head Trauma: Use of Rapid MR Imaging.

Author information

1
From the Departments of Radiology (H.M., J.A., L.L.) MehtaH@wcmc.com.
2
From the Departments of Radiology (H.M., J.A., L.L.).
3
Neurosurgery (A.L.M., M.E.T., D.J.), New York Medical College, Valhalla, New York.

Abstract

BACKGROUND AND PURPOSE:

With >473,000 annual emergency department visits for children with traumatic brain injuries in the United States, the risk of ionizing radiation exposure during CT examinations is a real concern. The purpose of this study was to assess the validity of rapid MR imaging to replace CT in the follow-up imaging of patients with head trauma.

MATERIALS AND METHODS:

A retrospective review of 103 pediatric patients who underwent initial head CT and subsequent follow-up rapid MR imaging between January 2010 and July 2013 was performed. Patients had minor head injuries (Glasgow Coma Scale, >13) that required imaging. Initial head CT was performed, with follow-up rapid MR imaging completed within 48 hours. A board-certified neuroradiologist, blinded to patient information and scan parameters, then independently interpreted the randomized cases.

RESULTS:

There was almost perfect agreement in the ability to detect extra-axial hemorrhage on rapid MR imaging and CT (κ = 0.84, P < .001). Evaluation of hemorrhagic contusion/intraparenchymal hemorrhage demonstrated a moderate level of agreement between MR imaging and CT (κ = 0.61, P < .001). The ability of MR imaging to detect a skull fracture also showed a substantial level of agreement with CT (κ = 0.71, P < .001). Detection of diffuse axonal injury demonstrated a slight level of agreement between MR imaging and CT (κ = 0.154, P = .04). However, the overall predictive agreement for the detection of an axonal injury was 91%.

CONCLUSIONS:

Rapid MR imaging is a valid technique for detecting traumatic cranial injuries and an adequate examination for follow-up imaging in lieu of repeat CT.

PMID:
26381555
DOI:
10.3174/ajnr.A4464
[Indexed for MEDLINE]
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