The Feasibility of Fast MRI to Reduce CT Radiation Exposure With Acute Traumatic Head Injuries.

Abstract

* Abbreviations: CT — : computed tomography ED — : emergency department TBI — : traumatic brain injury Traumatic brain injuries (TBIs) are among the most common causes of pediatric morbidity and mortality globally. After acute head trauma, children at risk for clinical deterioration must be identified rapidly and accurately, usually in the emergency department (ED) setting. Neuroimaging by computed tomography (CT) for pediatric head trauma proliferated rapidly in the late 1990s1 and remains the diagnostic gold standard for the identification of clinically important TBIs. Therein lies the problem: the risk of missing significant intracranial pathology must be weighted against the risks of radiation-induced malignancy associated with CT imaging.2–4 Reducing CT scans for head-injured children has been the focus of international research5–8 and educational campaigns for nearly 2 decades.9–11 Despite these long-standing efforts, neuroimaging of head-injured children by CT remains elevated.12 MRI presents a potentially attractive alternative to CT that would not expose children to the harmful effects of ionizing radiation. However, the use of MRI for pediatric head trauma has traditionally been limited by the need to remain motionless for a prolonged period and frequently necessitates procedural sedation with its additional inherent risks. A fast MRI protocol that is motion tolerant and sensitive for brain injury would curtail the limitations of conventional MRI. Previous … Address correspondence to Brett Burstein, MDCM, PhD, MPH, Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Center, 1001 Decarie Blvd, Montreal, QC H4C 3J1, Canada. E-mail: brett.burstein{at}mail.mcgill.ca