MR susceptibility weighted imaging and FLAIR sequence in the diagnosis of children with traumatic intracranial hemorrhage

Objective:To investigate the value of MR susceptibility weighted imaging(SWI)and fluid attenuated inversion recovery(FLAIR)sequence in the diagnosis of children with traumatic intracranial hemorrhage.Methods:A total of36 pediatric patients with traumatic brain injury and the age ranged from 3d~9y[(mean=2.6±2.6)y]were enrolled in this study.All patients underwent FLAIR sequence and SWI along with conventional MRI(cMRI)examination(including T1 WI,T2WI)by a 3.0T MR scanner.The differences of the 3approaches in displaying the volume of intracranial hemorrhage including cerebral micro-bleeding(CMBs),subdural/extradural hemorrhage(SDH/EDH),subarachnoid hemorrhage(SAH)and intraventricular hemorrhage(IVH)were compared,and the signal characteristics of various intracranial hemorrhage were analyzed.Results:Of the 36 patients,cMRI,SWI and FLAIR detected 80,197 and 65lesions of micro-bleeding respectively;45,45,44 lesions of SDH or EDH respectively;7,10,13 cases of SAH and 4,7,4cases with IVH respectively.In detecting microbleeding,there was significant difference between SWI and cMRI(P=0.001,χ2=166.419),as well as between SWI and FLAIR(P=0.001,χ2=198.504).In detecting SAH,there was statistical difference between FLAIR and cMRI(P=0.015).The signal appearances of intracranial hemorrhage were very complicated,and the hemorrhage signal especially for SDH/EDH on SWI was either hyper-intensity or heterogeneous.Conclusion:When compared with cMRI and FLAIR,SWI can detect much more intra-cerebral micro-bleeding and IVH.FLAIR has obvious advantages superior to cMRI in detecting SAH.Thus,the use of comprehensive MRI sequences has significant value in the diagnosis and prognosis prediction for children with traumatic intrcracranial hemorrhage.