Emergency Radiology

, Volume 23, Issue 4, pp 325–331 | Cite as

Comparison of non-sedated brain MRI and CT for the detection of acute traumatic injury in children 6 years of age or less

  • Joseph Yeen Young
  • Ann-Christine Duhaime
  • Paul Albert Caruso
  • Sandra Patricia Rincon
Original Article


CT is considered the first-line study for acute intracranial injury in children because of its availability, detection of acute hemorrhage, and lack of sedation. An MRI study with rapidly acquired sequences can obviate the need for sedation and radiation. We compared the detection rate of rapid non-sedated brain MRI to CT for traumatic head injury in young children. We reviewed a series of children 6 years of age or less who presented to our ED during a 5-year period with head trauma and received a non-sedated brain MRI and CT within 24 h of injury. Most MRI studies were limited to triplane T2 and susceptibility sequences. Two neuroradiologists reviewed the MRIs and CTs and assessed the following findings: fracture, epidural hematoma (EDH)/subdural hematoma (SDH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage (IVH), and parenchymal injury. Thirty of 33 patients had radiologically identified traumatic injuries. There was an overall agreement of 82 % between the two modalities. Skull fracture was the only injury subtype which had a statistically significant difference in detection between CT and MRI (p = 0.0001), with MRI missing 14 of 21 fractures detected on CT. While not statistically significant, MRI had a higher detection rate of EDH/SDH (p = 0.34), SAH (p = 0.07), and parenchymal injuries (p = 0.50). Non-sedated MRI has similar detection rates to CT for intracranial injury in young children presenting with acute head trauma and may be an alternative to CT in select patients.


Rapid MRI CT Brain Pediatric Trauma 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© American Society of Emergency Radiology 2016

Authors and Affiliations

  1. 1.Department of Radiology, Neuroradiology SectionMassachusetts General HospitalBostonUSA
  2. 2.Department of NeurosurgeryMassachusetts General HospitalBostonUSA

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