Imaging for anaesthetists: a review of the methods and anaesthetic implications of diagnostic imaging techniques

Magnetic resonance imaging in acute head injury

Using cardiorespiratory monitoring and support equipment compatible with a low field (0.15 T) system, magnetic resonance imaging (MRI) of patients suffering acute head injuries proved to be both feasible and safe. An abnormality was demonstrated by magnetic resonance imaging in 46 of 50 patients examined within 7 days of head injury using T2 weighted (SE2200/80) and T1 weighted (IR2000/600/40) multislice sequences. IN contrast, computed tomography (CT) demonstrated abnormalities in only 31 of the 50 patients. Intracranial extracerebral space-occupying collections of blood were well shown by magnetic resonance imaging which provided especially clear definition in the posterior fossa, subtemporal and subfrontal regions. Magnetic resonance imaging was more sensitive to cerebral abnormalities associated with traumatic unconsciousness and detected parenchymal lesions both in patients in coma and in those who had lost consciousness for only a few minutes. Lesions seen with MRI but not with CT included non-haemorrhagic contusions and abnormalities thought to reflect shearing injuries of white matter and intracerebral vessels. Magnetic resonance imaging is an effective alternative to CT; the additional information it can provide should be valuable in increasing the understanding of the early effects and late consequences of a head injury.