Role of Susceptibility-Weighted Imaging in Detecting Retinal Hemorrhages in Children with Head Trauma

Purpose This study was carried out to evaluate the utility of susceptibility-weighted imaging (SWI) in demonstrating retinal hemorrhages (RH) in pediatric head trauma. Methods Over a period of 7 years 67 children (age 0–4 years) with head trauma and MRI were included as either abusive head trauma (AHT) ( n = 23), non-abusive head trauma (NAHT) ( n = 38), or indeterminate ( n = 6). Two pediatric neuroradiologists jointly reviewed the MR images for the presence of RH and sensitivity and specificity of SWI and T2WI were calculated. Results The dilated fundoscopic examination (DFE) was positive for RH in 18/23 (78.3%) of the AHT group, 5/38 (13.2%) in the NAHT group, and 4/6 (66.7%) in the indeterminate group. Regarding the SWI MRI findings, SWI was positive for RH in 13/23 (%56.5), while T2WI was positive in 6/23 (%26.1) of the AHT group. Based on utilizing DFE as a standard, the sensitivity and specificity of SWI in the detection of RH was 63% and 100%, respectively and 30% and 100%, respectively on T2WI. Conclusion Our results suggest that SWI is a useful diagnostic tool for detection of RH in pediatric head trauma in whom DFE is difficult to perform.