ArticlePediatric radiology2015
MR detection of retinal hemorrhages: correlation with graded ophthalmologic exam.
Article in Pediatric radiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- Magnetic resonance imaging-based detection of retinal hemorrhages in a multicenter cohort of abusive head trauma.Pediatric radiology · 2026Article
- Evaluating a novel MR imaging biomarker for retinal hemorrhage.Pediatric radiology · 2025Article
- Utility of balanced steady-state field precession sequence in the evaluation of retinal and subdural hemorrhages in patients with abusive head trauma.Pediatric radiology · 2023Article
- Development of a Deep Learning Model for Retinal Hemorrhage Detection on Head Computed Tomography in Young Children.JAMA network open · 2023Article
- Is orbital susceptibility-weighted imaging superior to standard brain gradient echo sequences for detecting retinal hemorrhages?Pediatric radiology · 2022Article
- Role of Susceptibility-Weighted Imaging in Detecting Retinal Hemorrhages in Children with Head Trauma.Clinical neuroradiology · 2021Article
- Neuroimaging of retinal hemorrhage utilizing adjunct orbital susceptibility-weighted imaging.Pediatric radiology · 2021Review
- Magnetic resonance imaging of optic nerve and optic sheath hemorrhages in child abuse.Pediatric radiology · 2021Review
- Susceptibility-weighted imaging of retinal hemorrhages in abusive head trauma.Pediatric radiology · 2019Article
- [Medicolegal aspects of child abuse].Der Radiologe · 2016Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDilated fundoscopic exam is considered the gold standard for detecting retinal hemorrhage, but expertise in obtaining this exam is not always immediately available. MRI can detect retinal hemorrhages, but correlation of the grade or severity of retinal hemorrhage on dilated fundoscopic exam with retinal hemorrhage visibility on MRI has not been described.
objectiveTo determine the value of standard brain protocol MRI in detecting retinal hemorrhage and to determine whether there is any correlation with MR detection of retinal hemorrhage and the dilated fundoscopic exam grade of hemorrhage. MATERIALS AND
methodsWe conducted a retrospective chart review of 77 children <2 years old who were seen for head trauma from April 2007 to July 2013 and had both brain MRI and dilated fundoscopic exam or retinal camera images. A staff pediatric radiologist and radiology resident reviewed the MR images. Retinal hemorrhages were graded by a chief ophthalmology resident on a 12-point scale based on the retinal hemorrhage type, size, location and extent as seen on review of retinal camera images and detailed reports by ophthalmologists. Higher scores indicated increased severity of retinal hemorrhages.
resultsThere was a statistically significant difference in the median grade of retinal hemorrhage examination between children who had retinal hemorrhage detected on MRI and children who did not have retinal hemorrhage detected on MRI (P = 0.02). When examination grade was categorized as low-grade (1-4), moderate-grade (5-8) or high-grade (>8) hemorrhage, there was a statistically significant association between exam grade and diagnosis based on MRI (P = 0.008). For example, only 14% of children with low-grade retinal hemorrhages were identified on MRI compared to 76% of children with high-grade hemorrhages. MR detection of retinal hemorrhage demonstrated a sensitivity of 61%, specificity of 100%, positive predictive value of 100% and negative predictive value of 63%. Retinal hemorrhage was best seen on the gradient recalled echo (GRE) sequences.
conclusionMRI using routine brain protocol demonstrated 61% sensitivity and 100% specificity in detecting retinal hemorrhage. High-grade hemorrhage was more often detected on MRI than low-grade hemorrhage, 76% vs. 14%. GRE images were the most sensitive for detection of retinal hemorrhages. A dilated fundoscopic exam can be difficult to obtain in infancy, especially in critically ill or non-sedated children. MRI is a useful modality for added documentation of retinal hemorrhage and can be used as an alternative exam when ophthalmologic expertise or retinal camera images are unavailable. Additionally, identification of retinal hemorrhage on MRI can raise the possibility of abuse in children presenting with nonspecific findings.
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