Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury.

Thirty-five patients who had incurred head trauma were studied with computed tomography (CT) and magnetic resonance imaging (MRI). CT was performed using a General Electric 8800 scanner. MRI was conducted with a Technicare Teslacon system using a 5.0 kG (0.5 T) magnetic field. Clinically, patients varied from those with mild concussions without focal neurological signs to those with severe neurological dysfunction including posttraumatic coma. MRI was superior to CT in imaging 23 of 41 extracerebral fluid collections, both in estimating the size of the collections and in diagnosing small collections. MRI was also superior to CT in distinguishing chronic subdural hematomas from hygromas. Further, MRI was superior to CT in visualizing nonhemorrhagic contusion in 15 of 21 lesions. Because of the potential failure of MRI to diagnose acute subarachnoid or acute parenchymal hemorrhage, CT remains the procedure of choice in diagnosing head injury less than 72 hours old.