Head trauma is the most common indication for a CT scan. In this pilot study, the authors assess the feasibility of a 5-minute high-resolution 3D golden-angle (GA) stack-of-stars radial volumetric interpolated breath-hold examination (VIBE) MRI sequence (GA-VIBE) to obtain clinically acceptable cranial bone images and identify cranial vault fractures compared to CT.

Patients younger than 18 years of age presenting after head trauma were eligible for the study. Three clinicians reviewed and assessed 1) slice-by-slice volumetric CT and inverted MR images, and 2) 3D reconstructions obtained from inverted MR images and the gold standard (CT). For each image set, reviewers noted on 5-point Likert scales whether they recommended that a repeat scan be performed and the presence or absence of cranial vault fractures.

Thirty-one patients completed MRI after a clinical head CT scan was performed. Based on CT imaging, 8 of 31 patients had cranial fractures. Two of 31 patients were sedated as part of their clinical MRI scan. In 30 (97%) of 31 MRI reviews, clinicians agreed (or strongly agreed) that the image quality was acceptable for clinical diagnosis. Overall, comparing MRI to acceptable gold-standard CT, sensitivity and specificity of fracture detection were 100%. Furthermore, there were no discrepancies between CT and MRI in classification of fracture type or location.

When compared with the gold standard (CT), the volumetric and 3D reconstructed images using the GA-VIBE sequence were able to produce clinically acceptable cranial images with excellent ability to detect cranial vault fractures.

头部外伤是 CT 扫描最常见的指征。在这项试点研究中，作者评估了 5 分钟高分辨率 3D 黄金角 (GA) 星堆叠径向体积插值屏气检查 (VIBE) MRI 序列 (GA-VIBE) 的可行性与 CT 相比，可接受的颅骨图像和识别颅穹窿骨折。

头部外伤后出现的年龄小于 18 岁的患者符合研究条件。三位临床医生审查并评估了 1) 逐层体积 CT 和倒置 MR 图像，以及 2) 从倒置 MR 图像和金标准 (CT) 获得的 3D 重建。对于每个图像集，审阅者在 5 点李克特量表上指出他们是否建议进行重复扫描以及是否存在颅穹窿骨折。

31 名患者在进行临床头部 CT 扫描后完成了 MRI。根据 CT 成像，31 名患者中有 8 名有颅骨骨折。作为临床 MRI 扫描的一部分，31 名患者中有 2 名接受了镇静剂治疗。在 31 次 MRI 审查中，有 30 次（97%）的临床医生同意（或强烈同意）图像质量对于临床诊断是可以接受的。总体而言，将 MRI 与可接受的金标准 CT 进行比较，骨折检测的敏感性和特异性为 100%。此外，CT和MRI在骨折类型或位置分类上没有差异。

与金标准 (CT) 相比，使用 GA-VIBE 序列的体积和 3D 重建图像能够产生临床上可接受的颅骨图像，具有出色的颅穹窿骨折检测能力。