TY - JOUR
T1 - Detecting traumatic brain lesions in children
T2 - CT versus MRI versus susceptibility weighted imaging (SWI)
AU - Beauchamp, Miriam H
AU - Ditchfield, Michael
AU - Babl, Franz E
AU - Kean, Michael
AU - Catroppa, Cathy
AU - Yeates, Keith Owen
AU - Anderson, Vicki
PY - 2011/6/1
Y1 - 2011/6/1
N2 - Cranial CT scans are at the center of decision making in brain injuries in children because of their speed and ability to detect surgically relevant lesions. However, alternative techniques, such as conventional MRI may have advantages in terms of radiation exposure and sensitivity to detect brain injury. Susceptibility-weighted imaging (SWI), a relatively novel MRI sequence, shows promise in terms of its sensitivity in detecting hemorrhagic lesions; however, its clinical potential remains uncertain. In this observational study of children (5-16 years of age) with traumatic brain injury (TBI) at a tertiary pediatric emergency department (ED) we compared the ability of detecting traumatic brain lesions on acute CT and MRI/SWI ∼5 weeks post-injury based on detecting the presence or absence, extent, and type of traumatic brain lesions. We analyzed the results of 76 patients (53 male) after TBI (mean age 10.24±2.50 years, range 5.75-14.67 years). Glasgow Coma Score was 13-15 in 54 patients (71%), 9-12 in 13 patients (17%) and <8 in 9 patients (12%). CTs were completed in the ED; MRI and SWI were completed at a mean of 36.11±15.75 days post-injury. Detection of any lesions occurred on CT scan in 68%, on MRI in 54%, and on SWI in 86% of cases, and SWI detected additional lesions 30% of the time compared to CT and MRI. SWI may be more sensitive in detecting traumatic lesions than CT or MRI. This may be important for the ongoing management of TBIs and their prognosis.
AB - Cranial CT scans are at the center of decision making in brain injuries in children because of their speed and ability to detect surgically relevant lesions. However, alternative techniques, such as conventional MRI may have advantages in terms of radiation exposure and sensitivity to detect brain injury. Susceptibility-weighted imaging (SWI), a relatively novel MRI sequence, shows promise in terms of its sensitivity in detecting hemorrhagic lesions; however, its clinical potential remains uncertain. In this observational study of children (5-16 years of age) with traumatic brain injury (TBI) at a tertiary pediatric emergency department (ED) we compared the ability of detecting traumatic brain lesions on acute CT and MRI/SWI ∼5 weeks post-injury based on detecting the presence or absence, extent, and type of traumatic brain lesions. We analyzed the results of 76 patients (53 male) after TBI (mean age 10.24±2.50 years, range 5.75-14.67 years). Glasgow Coma Score was 13-15 in 54 patients (71%), 9-12 in 13 patients (17%) and <8 in 9 patients (12%). CTs were completed in the ED; MRI and SWI were completed at a mean of 36.11±15.75 days post-injury. Detection of any lesions occurred on CT scan in 68%, on MRI in 54%, and on SWI in 86% of cases, and SWI detected additional lesions 30% of the time compared to CT and MRI. SWI may be more sensitive in detecting traumatic lesions than CT or MRI. This may be important for the ongoing management of TBIs and their prognosis.
KW - child
KW - CT
KW - MRI
KW - SWI
KW - TBI
UR - http://www.scopus.com/inward/record.url?scp=79959711174&partnerID=8YFLogxK
U2 - 10.1089/neu.2010.1712
DO - 10.1089/neu.2010.1712
M3 - Article
C2 - 21501069
AN - SCOPUS:79959711174
SN - 0897-7151
VL - 28
SP - 915
EP - 927
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
IS - 6
ER -