TY - JOUR T1 - Value of Coronal Reformations in the CT Evaluation of Acute Head Trauma JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 334 LP - 339 DO - 10.3174/ajnr.A1824 VL - 31 IS - 2 AU - S.C. Wei AU - S. Ulmer AU - M.H. Lev AU - S.R. Pomerantz AU - R.G. González AU - J.W. Henson Y1 - 2010/02/01 UR - http://www.ajnr.org/content/31/2/334.abstract N2 - BACKGROUND AND PURPOSE: Routine axial CT images may not be ideally suited for detecting ICH in transversely oriented locations such as the floor of the anterior and middle cranial fossas and vertex. This study was performed to evaluate whether coronal reformations improve detection of ICH in NCCT performed for head trauma. MATERIALS AND METHODS: All patients undergoing a first NCCT in the ED for evaluation of head trauma were included prospectively during a 6-month interval. NCCT images were reconstructed into standard 5-mm axial datasets and were also reformatted into coronal datasets of 5-mm sections and 2.5-mm intervals. Thirty-two of 213 (15%) scans were interpreted as showing traumatic ICH. These cases were interspersed with 30 studies without ICH. Cases were reviewed for the presence and location of ICH by 2 staff neuroradiologists. RESULTS: Of 213 patients, 32 NCCTs demonstrated ICH (a total of 104 foci). Fifteen of 104 (14%) ICHs (8 patients) were detected solely on coronal images. Locations included the floor of the anterior and middle cranial fossas, vertex, corpus callosum, falx, tentorium, and occipital convexity. Coronal reformations allowed exclusion of suspicious findings on axial images in 14 instances (7 patients). Coronal images aided interpretation in 29/104 (28%) findings. CONCLUSIONS: Coronal reformations improve the detection of ICH over axial images alone, especially for lesions that lie in the axial plane immediately adjacent to bony surfaces. The use of coronal reformations should be considered in the routine interpretation of head CT examinations performed for the evaluation of head trauma. EDemergency departmentICHintracranial hemorrhageNCCTnoncontrast cranial CT ER -