Contribution of cranial MR bination with Ct in the ：在与CT结合头颅MR贡献.ppt

Contribution of cranial MR bination with CT in the initial evaluation of infants and children with non-accidental cerebral injury (NACI): Correlation with presence of retinal hemorrhages (RH)Kilpadikar, Anil*, Worthington, T.**, Jones, .**, Glasier, ***University of Arkansas for Medical Sciences**Arkansas Children’s HospitalLittle Rock, Arkansas
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Non-accidental Cerebral Injury (NACI)
NACI is the leading cause of death (USA) in children under 2 years of age
In children less than 1 year old, 95% of all serious head injuries and 64% of all head injuries result from maltreatment
e of infants suffering NACI is considerably worse than for those of the same age who have sustained ACI
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Purpose
Retrospectively study a large group of infants and children with documented NACI who had cranial CT, MR and ophthalmologic exam as part of an initial evaluation in order to determine:
Added utility of acute cranial MR, if any
Significance of retinal hemorrhage for prediction of severity of cerebral injury
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Materials and Methods
95 consecutive infants and children age newborn to 4 years admitted from 1999-2003 with documented NACI were reviewed
40 children in this group who had concurrent CT and MR near the time of admission were included in the study
CT exams were performed on the day of admission without contrast or sedation
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Materials and Methods
MR was performed within an average of 51 hrs. of the admission CT (range 0-12 days)
MR performed on a
Sequences included sagittal T1W, axial PD or FLAIR, T2W and GE images in all cases
27/40 (68%) had DW imaging
3/40 (%) had MRA
None had spectroscopy
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Materials and Methods
Patient records, CT and MR reports were reviewed retrospectively with specific attention to EDH, SDH, parenchymal hemorrhage (PH), cerebral ischemic change (CIC) and retinal hemorrhage (RH)
Presence of RH was correlated with severity of cerebral injury
Maximum cerebral injury score of 3 included presence of SDH or EDH (1point), PH