title: Susceptibility weighted imaging depicts retinal hemorrhages in abusive head trauma.
abstract: BACKGROUND
  This study aims to evaluate the capability of magnetic resonance imaging (MRI) susceptibility weighted images (SWI) in depicting retinal hemorrhages (RH) in abusive head trauma (AHT) compared to the gold standard dilated fundus exam (DFE).
  
  
  METHODS
  This is a retrospective, single institution, observational study on 28 patients with suspected AHT, who had a DFE and also underwent brain MRI-SWI as part of routine diagnostic protocol. Main outcome measures involved evaluation of patients to determine whether the RH could be identified on standard and high-resolution SWI sequences.
  
  
  RESULTS
  Of the 21 subjects with RH on DFE, 13 (62%) were identified by using a standard SWI sequence performed as part of brain MRI protocols. Of the 15 patients who also underwent an orbits SWI protocol, 12 (80%) were positive for RH. None of the seven patients without RH on of DFE had RH on either standard or high-resolution SWI. Compared with DFE, the MRI standard protocol showed a sensitivity of 75% which increased to 83% for the orbits SWI protocol.
  
  
  CONCLUSIONS
  Our study suggests the usefulness of a tailored high-resolution orbits protocol to detect RH in AHT.
authors.affiliation: Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA 15224, USA. giulio.zuccoli@gmail.com
authors.forename: Giulio
authors.initials: G
authors.lastname: Zuccoli
authors.forename: Ashok
authors.initials: A
authors.lastname: Panigrahy
authors.forename: Anshul
authors.initials: A
authors.lastname: Haldipur
authors.forename: Dennis
authors.initials: D
authors.lastname: Willaman
authors.forename: Janet
authors.initials: J
authors.lastname: Squires
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wolford
authors.forename: Christin
authors.initials: C
authors.lastname: Sylvester
authors.forename: Ellen
authors.initials: E
authors.lastname: Mitchell
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Lope
authors.forename: Ken K
authors.initials: KK
authors.lastname: Nischal
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Berger
mesh_terms: D002649:Child Abuse / Q000175:diagnosis*; D006259:Craniocerebral Trauma / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012166:Retinal Hemorrhage / Q000209:etiology* / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity