Diagnostic reliability of low dose multidetector CT and cone beam CT in maxillofacial trauma-an experimental blinded and randomized study.

Autor: Rozema R; 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands., Doff MH, van Ooijen PM; 2 Center for Medical Imaging - North East Netherlands (CMI-NEN2), University Medical Center Groningen, University of Groningen, Groningen , Groningen , The Netherlands.; 3 Department of Radiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands., Postmus D; 4 Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands., Westerlaan HE; 3 Department of Radiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands., Boomsma MF; 5 Department of Radiology, Isala Hospital , Zwolle , The Netherlands., van Minnen B; 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.
Jazyk: angličtina
Zdroj: Dento maxillo facial radiology [Dentomaxillofac Radiol] 2018 Dec; Vol. 47 (8), pp. 20170423. Date of Electronic Publication: 2018 May 31.
DOI: 10.1259/dmfr.20170423
Abstrakt: Objectives: To assess the diagnostic reliability of low dose multidetector CT (MDCT) and cone beam CT (CBCT) for zygomaticomaxillary fracture diagnosis.
Methods: Unilateral zygomaticomaxillary fractures were inflicted on four out of six fresh frozen human cadaver head specimens. All specimens were scanned using four MDCT and two CBCT imaging protocols of which the radiation exposure was systematically reduced. A blinded diagnostic routine was simulated at which 16 radiologists and 8 oral and maxillofacial (OMF) surgeons performed randomized image assessments. We considered the findings during an open operative approach of the zygomatic region as the gold standard.
Results: Zygomaticomaxillary fractures were correctly diagnosed in 90.3% (n = 130) of the image assessments. The zygomatic arch was most often correctly diagnosed (91.0%). The zygomatic alveolar crest showed the lowest degree of correct diagnosis (65.3%). Dose reduction did not significantly affect the objective visualization of fractures of the zygomaticomaxillary complex. The sensitivity and specificity also remained consistent among the low dose scan protocols. Dose reduction did not decrease the ability to assess dislocation, comminution, orbital volume, volume rendering and soft tissues. OMF surgeons considered the low dose protocols sufficient for treatment planning.
Conclusions: Dose reduction did not decrease the diagnostic reliability of MDCT and CBCT for the diagnosis of zygomaticomaxillary fractures.
Databáze: MEDLINE
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