Reformatted images improve the detection rate of acute traumatic subdural hematomas on brain CT compared with axial images alone

Subdural hematomas (SDHs) comprise a significant percentage of missed intracranial hemorrhage on axial brain CT. SDH detection rates could be improved with the addition of reformatted images. Though performed at some centers, the potential additional diagnostic sensitivity of reformatted images has...

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Bibliographic Details
Published in:Emergency radiology 2017-02, Vol.24 (1), p.39-45
Main Authors: Amrhein, Timothy J., Mostertz, William, Matheus, Maria Gisele, Maass-Bolles, Genevieve, Sharma, Komal, Collins, Heather R., Kranz, Peter G.
Format: Article
Language:English
Subjects:
Adult
Emergency Medicine
Female
Hematoma, Subdural - diagnostic imaging
Humans
Imaging
Imaging, Three-Dimensional
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Radiographic Image Interpretation, Computer-Assisted - methods
Radiology
Retrospective Studies
Sensitivity and Specificity
Software
Tomography, X-Ray Computed - methods
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Summary:Subdural hematomas (SDHs) comprise a significant percentage of missed intracranial hemorrhage on axial brain CT. SDH detection rates could be improved with the addition of reformatted images. Though performed at some centers, the potential additional diagnostic sensitivity of reformatted images has not yet been investigated. The purpose of our study is to determine if the addition of coronal and sagittal reformatted images to an axial brain CT increases the sensitivity and specificity for detection of acute traumatic SDH. We retrospectively reviewed consecutive brain CTs acquired for acute trauma that contained new SDHs. An equivalent number of normal brain CTs served as control. Paired sets of images were created for each case: (1) axial images only (“axial only”) and (2) axial, coronal, sagittal images (“reformat added”). Three readers interpreted both the axial only and companion reformat added for each case, separated by 1 month. Reading times and SDH detection rates were compared. One hundred SDH and 100 negative examinations were collected. Sensitivity and specificity for the axial-only scans were 75.7 and 94.3 %, respectively, compared with 88.3 and 98.3 % for reformat added. There was a 24.3 % false negative (missed SDH) rate with axial-only scans versus 11.7 % with reformat added ( p  = 
ISSN:1070-3004
1438-1435
DOI:10.1007/s10140-016-1440-z