Universität zu Köln

Cohrs, Gesa, Huhndorf, Monika, Niemczyk, Nils, Volz, Lukas J. ORCID: 0000-0002-0161-654X, Bernsmeier, Alexander, Singhal, Ash ORCID: 0000-0002-0061-9570, Larsen, Naomi, Synowitz, Michael and Knerlich-Lukoschus, Friederike (2018). MRI in mild pediatric traumatic brain injury: diagnostic overkill or useful tool? Childs Nerv. Syst., 34 (7). S. 1345 - 1353. NEW YORK: SPRINGER. ISSN 1433-0350

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Abstract

Magnetic resonance imaging (MRI) is a sensitive imaging tool which lacks the burden of ionizing radiation. It is not established as primary diagnostic tool in traumatic brain injury (TBI). The purpose of this study was to evaluate the usefulness of MRI as initial imaging modality in the emergency management of mild pediatric TBI. Children (0-18 years, sub-divided in four age-groups) with mild TBI who received MRI in the emergency department were identified. Clinical characteristics and trauma mechanisms were evaluated retrospectively. Univariate and multivariate logistic regression analyses were used to identify clinical factors that might be indicative for trauma sequelae on MRI scans. An institutional case series of 569 patients (322 male/247 female; age < 18years; (GCS ae<yen> 13), who received MRI for mild TBI, was analyzed. Multi-sequence imaging (including T2, T2*, FLAIR, and diffusion-weighted sequences) was feasible without sedation in 96.8% of cases (sedation, 1.8%; general anesthesia, 1.4%). MRI revealed trauma-associated findings in 13% of all cases; incidental findings were detected in 4.7%. In our cohort, GCS deterioration, scalp hematoma, clinical signs of skull base fractures, and horseback riding accidents were related to structural trauma sequelae on MRI. MRI is a practical primary imaging tool for evaluating children with mild TBI in the emergency department. The presented analyses demonstrated that in our institution, MRI imaging is performed frequently in the emergency department. It resulted mostly in normal findings. This may reflect uneasiness of when to perform imaging in mild TBI and appears retrospectively as an overdo. There are clinical factors that are more likely associated with MRI-positive findings. Their reliability has to be evaluated in prospective studies in order to formulate further decision rules of when to perform MRI imaging or not.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cohrs, Gesa UNSPECIFIED UNSPECIFIED UNSPECIFIED Huhndorf, Monika UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemczyk, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Volz, Lukas J. UNSPECIFIED orcid.org/0000-0002-0161-654X UNSPECIFIED Bernsmeier, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Singhal, Ash UNSPECIFIED orcid.org/0000-0002-0061-9570 UNSPECIFIED Larsen, Naomi UNSPECIFIED UNSPECIFIED UNSPECIFIED Synowitz, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Knerlich-Lukoschus, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-182236
DOI:	10.1007/s00381-018-3771-4
Journal or Publication Title:	Childs Nerv. Syst.
Volume:	34
Number:	7
Page Range:	S. 1345 - 1353
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0350
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPUTED-TOMOGRAPHY; RADIATION-EXPOSURE; CHILDREN; CT Multiple languages Clinical Neurology; Pediatrics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18223