What is the gold standard method for midline structures shift assessment using computed tomography?

摘要

In the June 2012 issue of Critical Care Medicine, Caricato et al (1) investigated the agreement between transcranial sonography and computed tomography (CT) after decompressive craniectomy. According to the authors, one of the main findings of this study is that transcranial sonography may be as effective as CT to assess the midline structures shift (MLS). This result is certainly of great interest as MLS above 0.5 cm has been shown to be associated with poor outcome (2). Considering methodological issues for comparing different methods, the gold standard method is certainly a critical point.