Role of Susceptibility-Weighted Imaging in Detecting Retinal Hemorrhages in Children with Head Trauma
Mehmet Gencturk1, Isa Cam2, Yasemin Koksel2
1Department of Radiology, Division of Neuroradiology, University of Minnesota Medical Center, 420 Delaware ST SE, 55455, Minneapolis, MN, USA. genct003@umn.edu.
Insights
Susceptibility-weighted imaging (SWI) effectively detects retinal hemorrhages (RH) in pediatric head trauma cases. This MRI technique offers high sensitivity and specificity, aiding diagnosis when fundoscopic exams are challenging.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Ophthalmology
Background:
- Retinal hemorrhages (RH) are a critical indicator in pediatric head trauma.
- Diagnosing RH can be challenging, especially in young children.
- Traditional methods like dilated fundoscopic examination (DFE) have limitations.
Purpose of the Study:
- To evaluate the diagnostic utility of susceptibility-weighted imaging (SWI) for detecting retinal hemorrhages (RH) in pediatric head trauma.
- To compare the sensitivity and specificity of SWI with T2-weighted imaging (T2WI) for RH detection.
Main Methods:
- A retrospective study included 67 children (0-4 years) with head trauma, categorized into abusive head trauma (AHT), non-abusive head trauma (NAHT), and indeterminate groups.
- Two pediatric neuroradiologists reviewed MRI scans for RH.
- Sensitivity and specificity of SWI and T2WI were calculated against DFE findings.
Main Results:
- DFE detected RH in 78.3% of AHT, 13.2% of NAHT, and 66.7% of indeterminate cases.
- SWI identified RH in 56.5% of AHT cases, compared to 26.1% for T2WI.
- SWI demonstrated a sensitivity of 63% and specificity of 100% for RH detection, outperforming T2WI (30% sensitivity, 100% specificity) when DFE was the standard.
Conclusions:
- SWI is a valuable tool for diagnosing retinal hemorrhages in pediatric head trauma.
- Its high specificity and improved sensitivity make it particularly useful when DFE is difficult to perform.
- SWI enhances the diagnostic capabilities in evaluating non-accidental head injuries in children.
Purpose:
This study was carried out to evaluate the utility of susceptibility-weighted imaging (SWI) in demonstrating retinal hemorrhages (RH) in pediatric head trauma.
Methods:
Over a period of 7 years 67 children (age 0-4 years) with head trauma and MRI were included as either abusive head trauma (AHT) (n = 23), non-abusive head trauma (NAHT) (n = 38), or indeterminate (n = 6). Two pediatric neuroradiologists jointly reviewed the MR images for the presence of RH and sensitivity and specificity of SWI and T2WI were calculated.
Results:
The dilated fundoscopic examination (DFE) was positive for RH in 18/23 (78.3%) of the AHT group, 5/38 (13.2%) in the NAHT group, and 4/6 (66.7%) in the indeterminate group. Regarding the SWI MRI findings, SWI was positive for RH in 13/23 (%56.5), while T2WI was positive in 6/23 (%26.1) of the AHT group. Based on utilizing DFE as a standard, the sensitivity and specificity of SWI in the detection of RH was 63% and 100%, respectively and 30% and 100%, respectively on T2WI.
Conclusion:
Our results suggest that SWI is a useful diagnostic tool for detection of RH in pediatric head trauma in whom DFE is difficult to perform.
