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Neuroimaging of retinal hemorrhage utilizing adjunct orbital susceptibility-weighted imaging

  • Child abuse imaging
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Abstract

Retinal hemorrhages are an integral part of the evaluation of abusive head trauma (AHT). Timely detection of retinal hemorrhage not only facilitates the diagnosis of AHT, but has the potential to prevent further abuse to the child and the siblings and to identify the abuser. The gold standard for diagnosing retinal hemorrhage is a dilated fundoscopy exam, which requires pharmacological dilation. As such, there is a small percentage of patients for whom the dilated fundoscopy exam might be delayed. Evolving literature suggests that MRI, specifically susceptibility-weighted imaging (SWI), of the orbits might provide an alternative diagnostic tool for noninvasively detecting retinal hemorrhages, particularly when there is a delay in administering the dilated fundoscopy exam. In this paper we review the utility of SWI for detecting retinal hemorrhages in abusive head trauma, including discussion of diagnostic limitations and future research.

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Authors and Affiliations

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

    Aashim Bhatia & Ashok Panigrahy

  2. Department of Radiology, Children’s Hospital Colorado, Aurora, CO, USA

    David M. Mirsky

  3. Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK

    Kshitij Mankad

  4. NDRD (Program for the Study in Neurodevelopment in Rare Disorders), University of Pittsburgh, Pittsburgh, PA, USA

    Giulio Zuccoli

  5. Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, Eye Center, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Ken K. Nischal

Authors
  1. Aashim Bhatia
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  2. David M. Mirsky
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  3. Kshitij Mankad
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  4. Giulio Zuccoli
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  5. Ashok Panigrahy
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  6. Ken K. Nischal
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Correspondence to Aashim Bhatia.

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Electronic supplementary material

Online Supplementary Material 1

Imaging in an 11-week-old boy with abusive head trauma. There is susceptibility of the posterior globes bilaterally, representing retinal hemorrhage on axial susceptibility-weighted imaging (M4V 874 kb)

Online Supplementary Material 2

Imaging in an 11-week-old boy with abusive head trauma. Oblique susceptibility-weighted imaging reformats show multiple foci of susceptibility, representing retinal hemorrhage up to the ora serrata (M4V 1,007 kb)

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Bhatia, A., Mirsky, D.M., Mankad, K. et al. Neuroimaging of retinal hemorrhage utilizing adjunct orbital susceptibility-weighted imaging. Pediatr Radiol 51, 991–996 (2021). https://doi.org/10.1007/s00247-020-04897-6

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  • DOI: https://doi.org/10.1007/s00247-020-04897-6

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