AVOIDING SKULL RADIOGRAPHS IN INFANTS WITH SUSPECTED INFLICTED INJURY WHO ALSO UNDERGO HEAD CT

Abstract Objectives To assess whether head CT with 3D reconstruction can replace skull radiographs (SXR) in the imaging investigation of suspected physical abuse (SPA)/abusive head trauma (AHT). Methods PACS was interrogated for antemortem skeletal surveys performed for SPA, patients younger than 2 years, SXR and CT performed within 4 days of each other. Paired SXR and CT were independently reviewed. One reviewer analysed CT without and (3 months later) with 3D reconstructions. SXR and CT expert consensus review formed the gold standard. Observer reliability was calculated. Results A total of 104 SXR/CT examination pairs were identified, mean age 6.75 months (range 4 days to 2 years); 21 (20%) had skull fractures; two fractures on CT were missed on SXR. There were no fractures on SXR that were not seen on CT. For SXR and CT, respectively: PPV reviewer 1, 95% confidence interval (CI) 48–82% and 85–100%; reviewer 2, 67–98% and 82–100%; and NPV reviewer 1, 95%, CI 88–98% and 96–100%; reviewer 2, 88–97% and 88–98%. Inter- and intra-observer reliability were respectively the following: SXR, excellent (kappa = 0.831) and good (kappa = 0.694); CT, excellent (kappa = 0.831) and perfect (kappa = 1). All results were statistically significant (p < 0.001). Conclusions CT has greater diagnostic accuracy than SXR in detecting skull fractures which is increased on concurrent review of 3D reconstructions and should be performed in every case of SPA/AHT. SXR does not add further diagnostic information and can be omitted from the skeletal survey when CT with 3D reconstruction is going to be, or has been, performed. Key Points • Head CT with 3D reconstruction is more sensitive and specific for the diagnosis of skull fractures. • Skull radiographs can be safely omitted from the initial skeletal survey performed for suspected physical abuse when head CT with 3D reconstruction is going to be, or has been, performed.

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Utility of Skull Radiographs in Infants Undergoing 3D Head CT During Evaluation for Physical Abuse

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2021.02.037 ◽

2021 ◽

Author(s):

Christopher Pennell ◽

Minal Aundhia ◽

Archana Malik ◽

Erica Poletto ◽

Harsh Grewal ◽

...

Keyword(s):

Physical Abuse ◽

Head Ct ◽

Skull Radiographs

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Natural head position recording on frontal skull radiographs

Acta Odontologica Scandinavica ◽

10.3109/00016358909004726 ◽

1989 ◽

Vol 42 (2) ◽

pp. 105-109

Author(s):

Jan Huggare

Keyword(s):

Head Position ◽

Skull Radiographs

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BHCNet: Neural Network based Brain Hemorrhage Classification Using Head CT Scan

IEEE Access ◽

10.1109/access.2021.3102740 ◽

2021 ◽

pp. 1-1

Author(s):

Muhammad Faheem Mushtaq ◽

Mobeen Shahroz ◽

Ali M. Aseere ◽

Habib Shah ◽

Rizwan Majeed ◽

...

Keyword(s):

Neural Network ◽

Ct Scan ◽

Brain Hemorrhage ◽

Head Ct

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Evaluation of age-based radiation dose in paediatric patients received from head CT examination at a tertiary hospital, Nigeria

Radiation Physics and Chemistry ◽

10.1016/j.radphyschem.2021.109380 ◽

2021 ◽

Vol 182 ◽

pp. 109380

Author(s):

Muhammad Kabir Abdulkadir ◽

Iliyasu Yusuf Izge ◽

Garba Haruna Yunusa ◽

Abacha Mohammed ◽

Noor Diyana Osman

Keyword(s):

Radiation Dose ◽

Tertiary Hospital ◽

Head Ct ◽

Ct Examination ◽

Paediatric Patients

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Enhancing Ant-Based Algorithms for Medical Image Edge Detection by Admissible Perturbations of Demicontractive Mappings

Symmetry ◽

10.3390/sym13050885 ◽

2021 ◽

Vol 13 (5) ◽

pp. 885

Author(s):

Vasile Berinde ◽

Cristina Ţicală

Keyword(s):

Edge Detection ◽

Medical Image ◽

Test Functions ◽

Head Ct ◽

X Ray ◽

Numerical Tests ◽

Image Edge Detection ◽

Evaluation Of Parameters ◽

Image Edge ◽

Demicontractive Mappings

The aim of this paper is to show analytically and empirically how ant-based algorithms for medical image edge detection can be enhanced by using an admissible perturbation of demicontractive operators. We thus complement the results reported in a recent paper by the second author and her collaborators, where they used admissible perturbations of demicontractive mappings as test functions. To illustrate this fact, we first consider some typical properties of demicontractive mappings and of their admissible perturbations and then present some appropriate numerical tests to illustrate the improvement brought by the admissible perturbations of demicontractive mappings when they are taken as test functions in ant-based algorithms for medical image edge detection. The edge detection process reported in our study considers both symmetric (Head CT and Brain CT) and asymmetric (Hand X-ray) medical images. The performance of the algorithm was tested visually with various images and empirically with evaluation of parameters.

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Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_362_18 ◽

2019 ◽

Vol 10 (02) ◽

pp. 207-211

Author(s):

Rajneesh K. Patel ◽

Amit Kumar Choubey ◽

Brijesh K. Soni ◽

Rajeev Sivasankar ◽

Vikash Chauhan

Keyword(s):

Computed Tomography ◽

Health Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Working Hours ◽

Care Hospital ◽

Head Ct ◽

Total Head ◽

Ct Head ◽

Head Computed Tomography

ABSTRACT Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient’s expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Materials and Methods: A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed. Results: About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively. Conclusion: Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals.

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