QuickBrain MRI for the detection of acute pediatric traumatic brain injury

Research output: Research - peer-reviewArticle

Abstract

OBJECTIVE The current gold-standard imaging modality for pediatric traumatic brain injury (TBI) is CT, but it confers risks associated with ionizing radiation. QuickBrain MRI (qbMRI) is a rapid brain MRI protocol that has been studied in the setting of hydrocephalus, but its ability to detect traumatic injuries is unknown. METHODS The authors performed a retrospective cohort study of pediatric patients with TBI who were undergoing evaluation at a single Level I trauma center between February 2010 and December 2013. Patients who underwent CT imaging of the head and qbMRI during their acute hospitalization were included. Images were reviewed independently by 2 neuroradiology fellows blinded to patient identifiers. Image review consisted of identifying traumatic mass lesions and their intracranial compartment and the presence or absence of midline shift. CT imaging was used as the reference against which qbMRI was measured. RESULTS A total of 54 patients met the inclusion criteria; the median patient age was 3.24 years, 65% were male, and 74% were noted to have a Glasgow Coma Scale score of 14 or greater. The sensitivity and specificity of qbMRI to detect any lesion were 85% (95% CI 73%-93%) and 100% (95% CI 61%-100%), respectively; the sensitivity increased to 100% (95% CI 89%-100%) for clinically important TBIs as previously defined. The mean interval between CT and qbMRI was 27.5 hours, and approximately half of the images were obtained within 12 hours. CONCLUSIONS In this retrospective pilot study, qbMRI demonstrated reasonable sensitivity and specificity for detecting a lesion or injury seen with neuroimaging (radiographic TBI) and clinically important acute pediatric TBI.

LanguageEnglish (US)
Pages259-264
Number of pages6
JournalJournal of neurosurgery. Pediatrics
Volume19
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Pediatrics
Traumatic Brain Injury
Retrospective Studies
Sensitivity and Specificity
Wounds and Injuries
Glasgow Coma Scale
Trauma Centers
Hydrocephalus
Ionizing Radiation
Neuroimaging
Gold
Hospitalization
Cohort Studies
Head
Brain

Keywords

  • child
  • ciTBI = clinically important traumatic brain injury
  • ED = emergency department
  • GCS = Glasgow Coma Scale
  • GRE = gradient echo
  • imaging
  • LOS = length of stay
  • PICU = pediatric intensive care unit
  • qbMRI = QuickBrain MRI
  • TBI = traumatic brain injury
  • trauma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "QuickBrain MRI for the detection of acute pediatric traumatic brain injury",
abstract = "OBJECTIVE The current gold-standard imaging modality for pediatric traumatic brain injury (TBI) is CT, but it confers risks associated with ionizing radiation. QuickBrain MRI (qbMRI) is a rapid brain MRI protocol that has been studied in the setting of hydrocephalus, but its ability to detect traumatic injuries is unknown. METHODS The authors performed a retrospective cohort study of pediatric patients with TBI who were undergoing evaluation at a single Level I trauma center between February 2010 and December 2013. Patients who underwent CT imaging of the head and qbMRI during their acute hospitalization were included. Images were reviewed independently by 2 neuroradiology fellows blinded to patient identifiers. Image review consisted of identifying traumatic mass lesions and their intracranial compartment and the presence or absence of midline shift. CT imaging was used as the reference against which qbMRI was measured. RESULTS A total of 54 patients met the inclusion criteria; the median patient age was 3.24 years, 65% were male, and 74% were noted to have a Glasgow Coma Scale score of 14 or greater. The sensitivity and specificity of qbMRI to detect any lesion were 85% (95% CI 73%-93%) and 100% (95% CI 61%-100%), respectively; the sensitivity increased to 100% (95% CI 89%-100%) for clinically important TBIs as previously defined. The mean interval between CT and qbMRI was 27.5 hours, and approximately half of the images were obtained within 12 hours. CONCLUSIONS In this retrospective pilot study, qbMRI demonstrated reasonable sensitivity and specificity for detecting a lesion or injury seen with neuroimaging (radiographic TBI) and clinically important acute pediatric TBI.",
keywords = "child, ciTBI = clinically important traumatic brain injury, ED = emergency department, GCS = Glasgow Coma Scale, GRE = gradient echo, imaging, LOS = length of stay, PICU = pediatric intensive care unit, qbMRI = QuickBrain MRI, TBI = traumatic brain injury, trauma",
author = "Sheridan, {David C.} and Newgard, {Craig D.} and Selden, {Nathan R.} and Jafri, {Mubeen A.} and Hansen, {Matthew L.}",
year = "2017",
month = "2",
doi = "10.3171/2016.7.PEDS16204",
volume = "19",
pages = "259--264",
journal = "Journal of neurosurgery. Pediatrics",
issn = "1933-0707",
publisher = "American Association of Neurological Surgeons",
number = "2",

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TY - JOUR

T1 - QuickBrain MRI for the detection of acute pediatric traumatic brain injury

AU - Sheridan,David C.

AU - Newgard,Craig D.

AU - Selden,Nathan R.

AU - Jafri,Mubeen A.

AU - Hansen,Matthew L.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - OBJECTIVE The current gold-standard imaging modality for pediatric traumatic brain injury (TBI) is CT, but it confers risks associated with ionizing radiation. QuickBrain MRI (qbMRI) is a rapid brain MRI protocol that has been studied in the setting of hydrocephalus, but its ability to detect traumatic injuries is unknown. METHODS The authors performed a retrospective cohort study of pediatric patients with TBI who were undergoing evaluation at a single Level I trauma center between February 2010 and December 2013. Patients who underwent CT imaging of the head and qbMRI during their acute hospitalization were included. Images were reviewed independently by 2 neuroradiology fellows blinded to patient identifiers. Image review consisted of identifying traumatic mass lesions and their intracranial compartment and the presence or absence of midline shift. CT imaging was used as the reference against which qbMRI was measured. RESULTS A total of 54 patients met the inclusion criteria; the median patient age was 3.24 years, 65% were male, and 74% were noted to have a Glasgow Coma Scale score of 14 or greater. The sensitivity and specificity of qbMRI to detect any lesion were 85% (95% CI 73%-93%) and 100% (95% CI 61%-100%), respectively; the sensitivity increased to 100% (95% CI 89%-100%) for clinically important TBIs as previously defined. The mean interval between CT and qbMRI was 27.5 hours, and approximately half of the images were obtained within 12 hours. CONCLUSIONS In this retrospective pilot study, qbMRI demonstrated reasonable sensitivity and specificity for detecting a lesion or injury seen with neuroimaging (radiographic TBI) and clinically important acute pediatric TBI.

AB - OBJECTIVE The current gold-standard imaging modality for pediatric traumatic brain injury (TBI) is CT, but it confers risks associated with ionizing radiation. QuickBrain MRI (qbMRI) is a rapid brain MRI protocol that has been studied in the setting of hydrocephalus, but its ability to detect traumatic injuries is unknown. METHODS The authors performed a retrospective cohort study of pediatric patients with TBI who were undergoing evaluation at a single Level I trauma center between February 2010 and December 2013. Patients who underwent CT imaging of the head and qbMRI during their acute hospitalization were included. Images were reviewed independently by 2 neuroradiology fellows blinded to patient identifiers. Image review consisted of identifying traumatic mass lesions and their intracranial compartment and the presence or absence of midline shift. CT imaging was used as the reference against which qbMRI was measured. RESULTS A total of 54 patients met the inclusion criteria; the median patient age was 3.24 years, 65% were male, and 74% were noted to have a Glasgow Coma Scale score of 14 or greater. The sensitivity and specificity of qbMRI to detect any lesion were 85% (95% CI 73%-93%) and 100% (95% CI 61%-100%), respectively; the sensitivity increased to 100% (95% CI 89%-100%) for clinically important TBIs as previously defined. The mean interval between CT and qbMRI was 27.5 hours, and approximately half of the images were obtained within 12 hours. CONCLUSIONS In this retrospective pilot study, qbMRI demonstrated reasonable sensitivity and specificity for detecting a lesion or injury seen with neuroimaging (radiographic TBI) and clinically important acute pediatric TBI.

KW - child

KW - ciTBI = clinically important traumatic brain injury

KW - ED = emergency department

KW - GCS = Glasgow Coma Scale

KW - GRE = gradient echo

KW - imaging

KW - LOS = length of stay

KW - PICU = pediatric intensive care unit

KW - qbMRI = QuickBrain MRI

KW - TBI = traumatic brain injury

KW - trauma

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U2 - 10.3171/2016.7.PEDS16204

DO - 10.3171/2016.7.PEDS16204

M3 - Article

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JO - Journal of neurosurgery. Pediatrics

T2 - Journal of neurosurgery. Pediatrics

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