Frontobasilar fractures: proposal for image reviewing algorithm.

Autor: Perheentupa U; Department of Otolaryngology - Head and Neck Surgery (Head: Prof. Reidar Grénman), Turku University Hospital and University of Turku, P.O. Box 52, FI-20521 Turku, Finland. Electronic address: ulla.perheentupa@utu.fi., Mäkitie AA; Department of Otolaryngology - Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Finland; School of Science, Department of Industrial Engineering and Management, BIT Research Centre, Aalto University, Finland., Karhu JO; Department of Radiology, Turku University Hospital and University of Turku, Finland., Koivunen P; Department of Otolaryngology - Head and Neck Surgery, Oulu University Hospital and University of Oulu, Finland., Blanco Sequieros R; Department of Radiology, Oulu University Hospital and University of Oulu, Finland., Kinnunen I; Department of Otolaryngology - Head and Neck Surgery (Head: Prof. Reidar Grénman), Turku University Hospital and University of Turku, P.O. Box 52, FI-20521 Turku, Finland.
Jazyk: angličtina
Zdroj: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2014 Jun; Vol. 42 (4), pp. 305-12. Date of Electronic Publication: 2014 Feb 11.
DOI: 10.1016/j.jcms.2013.05.018
Abstrakt: Objective: The aim of this study was to develop and test the utility of a novel systematic protocol to analyze CT images of patients with trauma in the anterior cranial base and upper midface.
Material and Methods: The radiological data and primary reports of 27 consecutive patients with a frontal skull base fracture treated in two tertiary care hospitals from 2007 to 2011 were scrutinized. A novel algorithm for systematic image reviewing was used to assess the CT images and the findings were compared with the primary radiological reports.
Results: The systematic review detected a substantial number of fractures and defects in anatomical structures that had not been systematically reported in the primary, on-call reports. Anterior skull base fracture was not initially reported in 32% of the patients; however, the algorithm detected this in 93% of them. The corresponding rates for fracture through cribriform plate were 28% and 72% and for fracture through the sella or hypophyseal area 22% and 78%. There were two fractures of the clivus and these were initially missed.
Conclusions: Despite the failure to identify these fractures radiologically in the primary setting, all patients were still considered to have received appropriate treatment, but, the use of an image-reviewing algorithm will enhance the specificity of CT in the diagnosis of frontobasilar fractures.
(Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: