平衡稳态场进动序列在评估虐待性头部创伤患者视网膜和硬膜下出血中的应用。
Utility of balanced steady-state field precession sequence in the evaluation of retinal and subdural hemorrhages in patients with abusive head trauma.
机构信息
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
出版信息
Pediatr Radiol. 2023 Aug;53(9):1842-1853. doi: 10.1007/s00247-023-05614-9. Epub 2023 Apr 20.
Abusive head trauma is the leading cause of physical child abuse deaths in children under 5 years of age in the United States. To evaluate suspected child abuse, radiologic studies are typically the first to identify hallmark findings of abusive head trauma including intracranial hemorrhage, cerebral edema, and ischemic injury. Prompt evaluation and diagnosis are necessary as findings may change rapidly. Current imaging recommendations include brain magnetic resonance imaging with the addition of a susceptibility weighted imaging (SWI) sequence which can detect additional findings that suggest abusive head trauma including cortical venous injury and retinal hemorrhages. However, SWI is limited due to blooming artifacts and artifacts from the adjacent skull vault or retroorbital fat, which can affect the evaluation of retinal, subdural, and subarachnoid hemorrhages. This work explores the utility of the high-resolution, heavily T2 weighted balanced steady-state field precession (bSSFP) sequence to identify and characterize retinal hemorrhage and cerebral cortical venous injury in children with abusive head trauma. The bSSFP sequence provides distinct anatomical images to improve the identification of retinal hemorrhage and cortical venous injury.
虐待性头部创伤是美国 5 岁以下儿童身体虐待死亡的主要原因。为了评估疑似虐待儿童,放射学研究通常是首先识别虐待性头部创伤的特征性发现,包括颅内出血、脑水肿和缺血性损伤。由于发现可能迅速变化,因此需要及时评估和诊断。目前的成像建议包括脑磁共振成像,外加磁敏感加权成像(SWI)序列,该序列可以检测到提示虐待性头部创伤的其他发现,包括皮质静脉损伤和视网膜出血。然而,SWI 受到 blooming 伪影和相邻颅骨穹窿或眶后脂肪的伪影的限制,这会影响对视网膜下、硬脑膜下和蛛网膜下腔出血的评估。这项工作探讨了高分辨率、重度 T2 加权平衡稳态场进动(bSSFP)序列在识别和特征化虐待性头部创伤儿童视网膜出血和大脑皮质静脉损伤中的效用。bSSFP 序列提供了独特的解剖图像,有助于提高对视网膜出血和皮质静脉损伤的识别。