Traumatic extra-axial hemorrhage: correlation of postmortem MSCT, MRI, and forensic-pathological findings

Añon, Javier; Remonda, Luca; Spreng, Adrian; Scheurer, Eva; Schroth, Gerhard; Boesch, Chris; Thali, Michael; Dirnhofer, Richard; Yen, Kathrin (2008). Traumatic extra-axial hemorrhage: correlation of postmortem MSCT, MRI, and forensic-pathological findings. Journal of magnetic resonance imaging, 28(4), pp. 823-36. Hoboken, N.J.: Wiley Interscience 10.1002/jmri.21495

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PURPOSE: To evaluate the diagnostic accuracy of in situ postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in the detection of primary traumatic extra-axial hemorrhage. MATERIALS AND METHODS: Thirty forensic neurotrauma cases and 10 nontraumatic controls who underwent both in situ postmortem cranial MSCT and MR imaging before autopsy were retrospectively reviewed. Both imaging modalities were analyzed in view of their accuracy, sensitivity, and specificity concerning the detection of extra-axial hemorrhage. Statistical significance was calculated using the McNemar test. kappa values for interobserver agreement were calculated for extra-axial hemorrhage types and to quantify the agreement between both modalities as well as MRI, CT, and forensics, respectively. RESULTS: Analysis of the detection of hemorrhagic localizations showed an accuracy, sensitivity, and specificity of 89%, 82%, and 92% using CT, and 90%, 83%, and 94% using MRI, respectively. MRI was more sensitive than CT in the detection of subarachnoid hemorrhagic localizations (P = 0.001), whereas no significant difference resulted from the detection of epidural and subdural hemorrhagic findings (P = 0.248 and P = 0.104, respectively). Interobserver agreement for all extra-axial hemorrhage types was substantial (CT kappa = 0.76; MRI kappa = 0.77). The agreement of both modalitites was almost perfect (readers 1 and 2 kappa = 0.88). CONCLUSION: CT and MRI are of comparable potential as forensic diagnostic tools for traumatic extra-axial hemorrhage. Not only of forensic, but also of clinical interest is the observation that most thin blood layers escape the radiological evaluation.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology > DCR Magnetic Resonance Spectroscopy and Methodology (AMSM)
UniBE Contributor:	Añon, Javier, Schroth, Gerhard, Boesch, Christoph Hans
ISSN:	1053-1807
ISBN:	18821624
Publisher:	Wiley Interscience
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:01
Last Modified:	02 Mar 2023 23:22
Publisher DOI:	10.1002/jmri.21495
PubMed ID:	18821624
Web of Science ID:	000259791300003
URI:	https://boris.unibe.ch/id/eprint/26691 (FactScience: 85662)