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Multiplanar reconstructed CT images increased depiction of intracranial hemorrhages in pediatric head trauma

  • Paediatric Neuroradiology
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Abstract

Introduction

The benefits of multiplanar reconstructed images (MPR) of unenhanced axial head computed tomography (CT) data have not been established in trauma patients younger than 3 years old, a population in which a reliable history and physical examination may be most difficult. We retrospectively evaluated unenhanced head CTs in pediatric trauma patients to investigate the various benefits of MPR in this age group.

Methods

A total of 221 unenhanced head CTs performed for any case of head trauma (HT) on children younger than 3 years old were independently reviewed by two radiologists. Studies were reviewed first in the standard axial plane alone and then with the addition of MPR. Reviewers were asked to determine if the MPR affected the ability to make findings of hemorrhage, incidental findings, and artifacts.

Results

MPR improved the detection of hemorrhage in 14 cases (6.5 %, p-value < 0.01) and incidental findings in five cases (2.3 %, p-value < 0.05) as well as helped prove artifacts in five cases (2.3 %, p-value < 0.05).

Conclusion

Routine use of MPR in HT patients younger than 3 years old has the potential to increase the detection of acute and incidental imaging findings.

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References

  1. Marin JR, Weaver MD, Yealy DM, Mannix RC (2014) Trends in visits for traumatic brain injury to emergency departments in the United States. JAMA 311(18):1917–1919. doi:10.1001/jama.2014.3979

    Article  CAS  PubMed  Google Scholar 

  2. Wei SC, Ulmer S, Lev MH, Pomerantz SR, González RG, Henson JW (2010) Value of coronal reformations in the CT evaluation of acute head trauma. AJNR Am J Neuroradiol 31(2):334–339. doi:10.3174/ajnr.A1824

    Article  CAS  PubMed  Google Scholar 

  3. Zacharia TT, Nguyen DT (2010) Subtle pathology detection with multidetector row coronal and sagittal CT reformations in acute head trauma. Emerg Radiol 17(2):97–102. doi:10.1007/s10140-009-0842-6

    Article  PubMed  Google Scholar 

  4. Ortega HW, Vander Velden H, Reid S (2012) Incidental findings on computed tomography scans in children with mild head trauma. Clin Pediatr 51(9):872–876. doi:10.1177/0009922812450508

    Article  Google Scholar 

  5. Vorona GA, Zuccoli G, Sutcavage T, Clayton BL, Ceschin RC, Panigrahy A (2013) The use of adaptive statistical iterative reconstruction in pediatric head CT: a feasibility study. AJNR Am J Neuroradiol 34(1):205–211. doi:10.3174/ajnr.A3122

    Article  CAS  PubMed  Google Scholar 

  6. Margulies SS, Thibault KL (2000) Infant skull and suture properties: measurements and implications for mechanisms of pediatric brain injury. J Biomech Eng 122(4):364–371

    Article  CAS  PubMed  Google Scholar 

  7. Feldman KW, Bethel R, Shugerman RP, Grossman DC, Grady MS, Ellenbogen RG (2001) The cause of infant and toddler subdural hemorrhage: a prospective study. Pediatrics 108(3):636–646

    Article  CAS  PubMed  Google Scholar 

  8. Thibault KL, Margulies SS (1998) Age-dependent material properties of the porcine cerebrum: effect on pediatric inertial head injury criteria. J Biomech 31(12):1119–1126

    Article  CAS  PubMed  Google Scholar 

  9. Kemp AM, Jaspan T, Griffiths J, Stoodley N, Mann MK, Tempest V, Maguire SA (2011) Neuroimaging: what neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review. Arch Dis Child 96(12):1103–1112. doi:10.1136/archdischild-2011-300630

    Article  CAS  PubMed  Google Scholar 

  10. Yamashima T, Friede RL (1984) Why do bridging veins rupture into the virtual subdural space? J Neurol Neurosurg Psychiatry 47(2):121–127

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Aitken LA, Lindan CE, Sidney S, Gupta N, Barkovich AJ, Sorel M, Wu YW (2009) Chiari type I malformation in a pediatric population. Pediatr Neurol 40(6):449–454. doi:10.1016/j.pediatrneurol.2009.01.003

    Article  PubMed Central  PubMed  Google Scholar 

  12. Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de González A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380(9840):499–505. doi:10.1016/S0140-6736(12)60815-0

    Article  PubMed Central  PubMed  Google Scholar 

  13. Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, Giles GG, Wallace AB, Anderson PR, Guiver TA, McGale P, Cain TM, Dowty JG, Bickerstaffe AC, Darby SC (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 346:f2360. doi:10.1136/bmj.f2360

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the UPMC Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Section of Neuroradiology, Children’s Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA

    Stacey Langford, Ashok Panigrahy, Srikala Narayanan, Misun Hwang, Charles Fitz, Lynda Flom, Vincent Kyu Lee & Giulio Zuccoli

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  1. Stacey Langford
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  2. Ashok Panigrahy
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  3. Srikala Narayanan
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  4. Misun Hwang
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  5. Charles Fitz
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  6. Lynda Flom
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  7. Vincent Kyu Lee
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  8. Giulio Zuccoli
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Corresponding author

Correspondence to Giulio Zuccoli.

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Langford, S., Panigrahy, A., Narayanan, S. et al. Multiplanar reconstructed CT images increased depiction of intracranial hemorrhages in pediatric head trauma. Neuroradiology 57, 1263–1268 (2015). https://doi.org/10.1007/s00234-015-1584-7

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  • DOI: https://doi.org/10.1007/s00234-015-1584-7

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