Comparison of the diagnostic accuracy of cone beam computed tomography and radiography for scaphoid fractures.

Autor:	Neubauer J; Department of Radiology, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany. jakob.neubauer@uniklinik-freiburg.de., Benndorf M; Department of Radiology, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Ehritt-Braun C; Department of Radiology, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Reising K; Department of Orthopaedics and Trauma Surgery, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Yilmaz T; Department of Orthopaedics and Trauma Surgery, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Klein C; Department of Radiology, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Zajonc H; Department of Plastic and Hand Surgery, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Kotter E; Department of Radiology, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Langer M; Department of Radiology, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany., Goerke SM; Department of Radiology, Ortenau Klinikum Offenburg-Gengenbach, Ebertplatz 12, 77654, Offenburg, Germany.
Jazyk:	angličtina
Zdroj:	Scientific reports [Sci Rep] 2018 Mar 02; Vol. 8 (1), pp. 3906. Date of Electronic Publication: 2018 Mar 02.
DOI:	10.1038/s41598-018-22331-8
Abstrakt:	The aim of this study was to evaluate and compare the diagnostic accuracy, the inter-rater agreement and raters' certainty of cone beam computed tomography (CBCT) and radiography for the detection of scaphoid fractures. Our hypothesis is that the CBCT has a higher diagnostic accuracy for scaphoid fractures than radiography. We retrospectively analysed patients who underwent both radiography and CBCT examinations within 4 days to rule out a scaphoid fracture over a 2-year period in our institution. 4 blinded radiologists and orthopaedic surgeons independently rated the images regarding the presence of a scaphoid fracture. The reference standard was evaluated by two radiologists in a consensus reading. Inter-rater correlation was evaluated, pooled sensitivity, specificity, positive and negative predictive values were calculated and compared. 102 patients met the inclusion criteria. 52% of them had a scaphoid fracture. The inter-rater correlation was higher in the CBCT compared to radiography (P < 0.001). Sensitivity, specificity, positive and negative predictive values were higher for CBCT than for radiography (P < 0.019). Observers' fracture classifications showed a higher correlation with the reference standard in the CBCT. Observers' certainty for fracture detection and classification were higher in the CBCT. CBCT shows a higher diagnostic accuracy for scaphoid fractures than radiography.
Databáze:	MEDLINE
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