CASE REPORT


Hemicerebrum Infarction or Artifact: Effects of Out-of Center Positioning



Rob Westerlaken1, Antoine van der Linden2, Laurien Oosterwijk1, Levinus Bok1, Carola van Pul3, Feico Halbertsma1, *
1 Department of Pediatrics, Máxima Medical Center, Veldhoven, Netherlands
2 Department of Radiology, Máxima Medical Center, Veldhoven, Netherlands
3 Department of Clinical Physics, Máxima Medical Center, Veldhoven, Netherlands


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Creative Commons License
© 2020 Westerlaken et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Pediatrics, Maxima Medical Centre, De Run 4600, 5504 DB Veldhoven, Netherlands;
Tel: 0031 40 888 8270; Fax: 0031 40 888 9609; E-mail: f.halbertsma@mmc.nl


Abstract

Background:

CT scans are widely used for their ability to easily and rapidly obtain medical information. However, they are also vulnerable for artifacts. Fortunately, the majority is easily recognizable or is so well known that they are included in differential diagnosis on interpreting CT and rarely cause misdiagnosis or additional investigations.

Methods:

We report 2 infants with rare CT hemicerebrum density differences. They were not consistent with the clinical condition of the patients and could be classified as being artifacts after MRI proved to be normal. Retrospectively, this could have been detected on CT by examining the eyes, which also showed not otherwise explicable density differences.

Results:

These artifacts appeared to be caused by out-of center positioning, as we could demonstrate with experimental phantom scanning. We have not found any previous reports on this type of artifact.

Conclusion:

Recognition of this specific type of artifacts by observing similar density differences in the eyes does prevent unnecessary additional imaging.

Keywords: CT cerebrum, Artifacts, Out-of center positioning, Out of field artifact, Incomplete projection artifact, Cerebrum, CDTI phantom.