Value of Coronal Reformations in the CT Evaluation of Acute Head Trauma

Wei, Shouyi; Ulmer, Stephan; Lev, Michael H.; Pomerantz, Stuart R.; González, Ramón; Henson, John W.

doi:10.3174/ajnr.a1824

Cited by 44 publications

(29 citation statements)

References 11 publications

(11 reference statements)

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“…A few studies have assessed the added value of three-dimensional (3D) reformations versus transverse plane views in the evaluation of cranial CT examinations (5,6). To our knowledge, however, no reported study has evaluated the effect of 3D reformatted images on radiology residents' performance.…”

Section: Resultsmentioning

confidence: 99%

Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

Kim

Yoon²,

Lee³

et al. 2014

Diagn Interv Radiol

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NEURORADIOLOGYORIGINAL ARTICLE PURPOSE Three-dimensional (3D) reformatted images provide a more inclusive representation of abnormalities than transverse images in cranial computed tomography (CT). The purpose of this study was to assess the value of 3D reformations for radiology residents in the interpretation of emergency cranial CTs. MATERIALS AND METHODSIn total, 218 consecutive patients who underwent emergency cranial CT scans with 3D reformation were included in this retrospective study. Four blinded readers (three radiology residents and a neuroradiologist) interpreted the transverse and 3D images in two separate sessions. Each reader assessed 1) abnormal finding(s) and the confidence score(s) (5-point scale) for transverse and 3D images, 2) added value score of 3D images (5-point scale), and 3) interpretation time for both transverse and 3D images. We analyzed discordance between each radiology resident and the neuroradiologist on a lesion-by-lesion basis. RESULTSIn total, 509 lesions were detected in 218 patients. Discordance rates between the three residents and the neuroradiologist were 11.4%-20.2% (mean, 15.0%) and 8.8%-16.9% (mean, 12.1%) in the interpretation of transverse and 3D images, respectively. Confidence scores were higher for 3D images than for transverse images for all readers. The added value scores for the 3D images were relatively higher for the inexperienced residents. Interpretation times for 3D images were significantly higher than for transverse images for all readers. CONCLUSIONThe 3D reformations assist radiology residents in the interpretation of emergency cranial CT examinations. U nenhanced cranial computed tomography (CT) is the primary imaging modality for the emergency evaluation of patients with acute neurological deficits because of its wide availability, speed, costeffectiveness, and ability to assess less stable patients (1). Although some institutions may have 24-hour CT interpretation by an experienced neuroradiologist, many hospitals provide overnight coverage for CT studies by an on-call radiology resident. The final interpretation is then provided by attending neuroradiologists, usually the next day. Thus, accurate initial interpretation of cranial CT scans by the resident is critical for proper patient management.A few studies have investigated discordance between radiology residents and neuroradiologists in the interpretation of unenhanced cranial CT scans and they reported discordance rates in the range of 2.1%-8.3% (2-4). This discordance rate may be influenced by several factors, such as the resident's level of training, prevalence and type of disease, and imaging technique (e.g., resolution, display, image plane).A few studies have assessed the added value of three-dimensional (3D) reformations versus transverse plane views in the evaluation of cranial CT examinations (5, 6). To our knowledge, however, no reported study has evaluated the effect of 3D reformatted images on radiology residents' performance.The aim of this study was to assess the value of 3D ref...

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Section: Resultsmentioning

confidence: 99%

Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

Kim

Yoon²,

Lee³

et al. 2014

Diagn Interv Radiol

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“…Our findings indicate that small collections can be both overlooked and undetectable with CT imaging, even when using reformations, which has been shown to improve detection in living patients. 4 It has been previously demonstrated that a limitation of CT virtual autopsy is the possibility of missing very small collections of blood. Yen et al 5 evaluated postmorten brains with traumatic injury and found that CT had a sensitivity of 73% for the detection of subdural hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Common and Expected Postmortem CT Observations Involving the Brain: Mimics of Antemortem Pathology

Smith

Lattin

Berran³

et al. 2012

AJNR Am J Neuroradiol

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“…19,20 Evaluation of coronal images in HL is important for disease bulk positioned obliquely in the mediastinum or for conglomerate lymph node mass extending along the cranio-caudal axis, such as involvement of contiguous cervical, supraclavicular, and infraclavicular lymph nodes. We found additional patients (approx.…”

Section: Discussionmentioning

confidence: 99%

Definition of bulky disease in early stage Hodgkin lymphoma in computed tomography era: prognostic significance of measurements in the coronal and transverse planes

et al. 2016

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Value of Coronal Reformations in the CT Evaluation of Acute Head Trauma

Cited by 44 publications

References 11 publications

Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

Common and Expected Postmortem CT Observations Involving the Brain: Mimics of Antemortem Pathology

Definition of bulky disease in early stage Hodgkin lymphoma in computed tomography era: prognostic significance of measurements in the coronal and transverse planes

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