Subtle pathology detection with multidetector row coronal and sagittal CT reformations in acute head trauma

T. Thomas Zacharia, Dan T.D. Nguyen

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

We sought to analyze retrospectively the advantages of coronal and sagittal reformations obtained with multidetector row computed tomography (CT) in patients with acute head trauma. Multidetector 16-section CT was performed in 200 patients (110 male and 90 female; age range, 3-87 years; mean age, 45 years) with acute head trauma. Scans were performed sequentially, and axial 5-mm-thick slices were obtained from base of skull to vertex. The source data set was reformatted in coronal and sagittal planes, with 2-mm-thick sections at 2-mm intervals. Images were analyzed retrospectively by two independent, blinded readers. The final diagnosis was determined by clinical follow-up. CT imaging abnormalities were detected in 55 out of 200 patients who were scanned for head trauma. Acute traumatic intracranial abnormality was detected on axial scans in 45 patients. Subtle findings were confirmed on coronal and sagittal CT reformations in ten cases, and these were undetected initially on axial CT. Coronal and sagittal reformations confirmed subtle findings in 18.2% (10/55) of the cases (P∈=∈0.001). Indeterminate neuroimaging findings confirmed by coronal and sagittal CT head reformations include tentorial and interhemispheric fissure subdural hemorrhage, subarachnoid hemorrhage, and inferior frontal and temporal lobe contusions. Coronal and sagittal CT head reformations improve the sensitivity and diagnostic confidence in the clinical setting of acute trauma. Overall, coronal and sagittal reformations improved diagnostic confidence and interobserver agreement over axial images alone for visualization of normal structures and in the diagnosis of acute abnormality.

Original languageEnglish (US)
Pages (from-to)97-102
Number of pages6
JournalEmergency Radiology
Volume17
Issue number2
DOIs
StatePublished - Mar 1 2010

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Craniocerebral Trauma
Tomography
Pathology
Head
Subdural Hematoma
Multidetector Computed Tomography
Contusions
Skull Base
Frontal Lobe
Temporal Lobe
Subarachnoid Hemorrhage
Neuroimaging
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

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Subtle pathology detection with multidetector row coronal and sagittal CT reformations in acute head trauma. / Zacharia, T. Thomas; Nguyen, Dan T.D.

In: Emergency Radiology, Vol. 17, No. 2, 01.03.2010, p. 97-102.

Research output: Contribution to journalArticle

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