Benefits of Low-Dose CT Scan of Head for Patients With Intracranial Hemorrhage

Wu, Dan; Wang, Gang; Bian, Bingyang; Liu, Zhuohang; Li, Dan

doi:10.1177/1559325820909778

Cited by 9 publications

(7 citation statements)

References 26 publications

(31 reference statements)

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“…Nevertheless, most studies discussing radiation risks in children were published more than 10 years ago or are based on data obtained even before the millennium. The newer generation of CT scanners can perform low-dose CT protocols with reduced radiation exposure of 45–50% [ 23 , 24 ]. Therefore, future studies should investigate the risks of radiation exposure in children after low-dose CT scans for reasonable comparisons with the benefits and disadvantages of whole-body MRI after high-energy trauma.…”

Section: Introductionmentioning

confidence: 99%

Full-body MR imaging: a retrospective study on a novel diagnostic approach for children sustaining high-energy trauma

Ludwig

Heumann

Gümbel

et al. 2021

Eur J Trauma Emerg Surg

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Purpose Severe accidents are the leading cause of long-term impairment and death in children. A common diagnostic procedure for children exposed to high-injury trauma is full-body contrast-enhanced CT (fbCT). However, the number of fbCT without detected injuries is relevant. In 2007, full-body MRI (fbMRI) was implemented as a diagnostic approach for children sustaining high-energy trauma. The aim of this cross-sectional retrospective study was to analyze fbMRI as a diagnostic tool for children after high-energy trauma focusing on feasibility, radiological findings, and limitations. Methods Diagnostics using fbMRI (from apex of the head to the pelvis) was performed if a child was stable and suffered a high-energy trauma in a Level I Trauma Center in Germany. 105 fbMRIs in patients exposed to high-energy trauma aged ≤ 16 years were performed between January 2007 and December 2018. Four fbMRIs were excluded as conducted for reasons other than trauma. Time between arrival in the emergency department and fbMRI, additional diagnostic procedures, injuries, and non-trauma related pathologies were analyzed. Results Mean time between arrival in the emergency department and fbMRI was 71 min (± SD 132 min). Two scans were discontinued and changed to a faster diagnostic procedure. 45% of children had additional X-rays and 11% CT scans. The MRIs showed intracranial abnormalities in 27%, extremities injuries in 26%, spinal injuries in 18%, pelvic, and thoracic injuries in 7% of the cases. Conclusion Overall fbMRI is a diagnostic alternative for hemodynamically stable, conscious children after high-energy trauma with the advantages of a radiation-free technique. However, MRI diagnostics take longer than CT scans. Prospective studies will be needed to identify the limiting factors of fbMRIs as primary diagnostic procedure compared to CT scans. Trial registration German Clinical Trials Register (DRKS; DRKS00017015). Level of evidence Case series, level of evidence V.

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Section: Introductionmentioning

confidence: 99%

Full-body MR imaging: a retrospective study on a novel diagnostic approach for children sustaining high-energy trauma

Ludwig

Heumann

Gümbel

et al. 2021

Eur J Trauma Emerg Surg

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“…Later, there have been some studies where experts have analyzed the application of low-dose CT scanning in the detection of a cerebral hemorrhage. e results indicate that the low-dose CT scan can achieve the same effect as routine dose CT scan in the examination of patients with cerebral hemorrhage and is conducive to reducing the radiation impact on patients, so it has a good application value [8,21]. A recent meta-analysis has shown that, in the low-dose CT imaging of patients with atherosclerotic subarachnoid hemorrhage, if the radiation dose is reduced to 40% of the original dose level, the accuracy of the diagnosis of cerebral perfusion injury will not be affected [7].…”

Section: Discussionmentioning

confidence: 91%

“…At the present stage, the main means of examination for suspected patients with intracerebral hemorrhage is a craniocerebral computed tomography (CT) scan. However, as the condition of intracerebral hemorrhage is prone to recurrence and changes, multiple scans of intracerebral hemorrhage patients are needed to determine the condition of the disease, so that the clinical treatment plan can be changed [7,8]. e images scanned by CT with the features of high resolution, clear pixels, and no artifacts can provide clear diagnostic evidence for the clinical treatment of patients.…”

Section: Introductionmentioning

confidence: 99%

Values of Sinogram Affirmed Iterative Reconstruction Algorithm-Based Low-Dose Computed Tomography Imaging in Clinical Diagnosis of Cerebral Hemorrhage

Wang

Chen

Fang

et al. 2021

Scientific Programming

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In this study, the sinogram affirmed iterative reconstruction (SAFIRE) technology combined with low-dose computed tomography (CT) scanning technology was applied to scan patients with cerebral hemorrhage to evaluate the application value of this combined technology in the diagnosis of patients with cerebral hemorrhage. 132 patients with cerebral hemorrhage admitted to the hospital were selected randomly as the research objects in this study. According to the patients’ wishes, all of them were rolled into an experimental group and a control group. Besides, patients who were willing to use low-dose CT imaging scanning technology based on the SAFIRE algorithm were classified into the experimental group, and those who received simple low-dose CT scans were classified into the control group. Subjective score, objective score (mean CT value), image noise (SD), signal-to-noise ratio (SNR), and contrast-noise ratio (CNR) were used to analyze and compare the two groups of detection methods. The results showed the following: (1) The average result of CT images was 4.05 ± 0.28 points for the control group and 4.43 ± 0.59 points for the experimental group. According to the classification, the excellent and good rates of the experimental group (89.9%) were markedly higher than the rates of the control group (65.8%), with a statistically obvious difference ( P < 0.05). (2) The standard deviation (SD), image signal-to-noise ratio (SNR), and contrast-noise ratio (CNR) results of gray matter, white matter, and cerebral hemorrhage lesions of patients from the experimental group were better than those of the control group, and the differences were statistically significant ( P < 0.05). In conclusion, the image quality of a low-dose CT scan reconstructed by the SAFIRE algorithm was superior to that of a simple low-dose CT scan. In other words, the image quality of CT images could be guaranteed by the SAFIRE technology under the condition of reducing radiation dose. It enabled patients with cerebral hemorrhage to carry out diagnostic examinations with guaranteed accuracy under the risk of low radiation and provided better imaging services for patients with cerebral hemorrhage.

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“…In the subject image quality assessment (1) severity of background noise, (2) severity of imaging artifacts, and (3) clarity of demonstration of lesions and anatomical structure were taken into account. 18 , 19 Five grades were designed to each factor, with 5 representing the best quality ( Table 1 ). The scores from the 3 domains determined by the 2 neuroradiologists were then averaged to generate an overall score for image quality.…”

Section: Methodsmentioning

confidence: 99%

A Preliminary Study of Personalized Head CT Scan in Pediatric Patients

et al. 2021

Self Cite

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Objectives: In the present study, we introduced a practical approach to quantify organ-specific radiation doses and investigated whether low-dose head circumference (HC)-based protocols for non-enhanced head computed tomography (CT) could reduce organs-specific radiation dose in pediatric patients while maintaining high image quality. Methods: A total of 83 pediatric patients were prospectively recruited. Without limits to the HC, 15 patients were selected as a convention group (CON group) and underwent non-enhanced head CT scan with standard-dose protocols (tube current-time products of 250mAs). Low-dose group (LD group), including remaining 68 pediatrics were divided into 3 subgroups based on the HC: 54.1-57.0 cm for LD200mAs group (HC-based protocols of 200mAs), 51.1-54.0 cm for LD150mAs group (HC-based protocols of 150mAs), 48.1-51.0 cm for LD100mAs group (HC-based protocols of 100mAs). Subjective and objective image quality was evaluated and measured by 2 experienced radiologists. Radimetrics was used to calculate organs-specific radiation dose, including the brain, eye lenses, and salivary glands. Results: In CON250mAs group, radiation doses in the brain and salivary glands were conversely correlated with HC, and pediatric patients with smaller HC received higher organs-specific radiation dose. Reducing tube current-time product from 250 to 100mAs could significantly reduce the organ-specific radiation dose. The subjective image quality score ≥ 3.0 is acceptable for diagnosis purposes. The signal to noise ratio (SNR) and the contrast to noise ratio (CNR) of bilateral thalamus and centrum semiovale in 3 LD subgroups were not statistically different compared with the CON group. Conclusion: Our research indicated that low-dose HC-based protocols of non-enhanced head CT scan can evidently reduce the organ-specific radiation doses, while maintaining high image quality. HC can serve as a vital tool to guide personalized low-dose head CT scan for pediatric patients.

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Benefits of Low-Dose CT Scan of Head for Patients With Intracranial Hemorrhage

Cited by 9 publications

References 26 publications

Full-body MR imaging: a retrospective study on a novel diagnostic approach for children sustaining high-energy trauma

Full-body MR imaging: a retrospective study on a novel diagnostic approach for children sustaining high-energy trauma

Values of Sinogram Affirmed Iterative Reconstruction Algorithm-Based Low-Dose Computed Tomography Imaging in Clinical Diagnosis of Cerebral Hemorrhage

A Preliminary Study of Personalized Head CT Scan in Pediatric Patients

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