Diagnostic maxillofacial coronal images reformatted from helically acquired thin-section axial CT data

OBJECTIVE, This study was undertaken to determine the sensitivity and speci ficity of coronal images reformatted from helical thin-section axial CT dat a obtained for the evaluation of maxillofacial fractures. MATERIALS AND METHODS, Multiple fractures were created in nine cadaver head s by blunt trauma and were then evaluated using a late-generation helical C T scanner. Two neuroradiologists then independently evaluated the axial and reformatted coronal maxillofacial images. Subsequently, they reviewed the axial and direct coronal CT images, which were considered the criterion sta ndard, RESULTS, A total of 87 fractures were identified. An experienced neuroradio logist failed to identify one displaced fracture and two nondisplaced fract ures when evaluating the reformatted coronal and direct axial images for an overall sensitivity of 97%. A less experienced neuroradiologist failed to identify a total of five minimally displaced or nondisplaced fractures for an overall sensitivity of 94%. For each radiologist, no significant differe nce in the time required to interpret the direct versus the reformatted cor onal images was seen. CONCLUSION, interpretation of axial and reformatted coronal images resulted in accurate identification of displaced maxillofacial fractures in cadaver s. This study suggests that the: added cost and radiation exposure associat ed with incremental direct coronal CT may not he necessary for detection of clinically significant maxillofacial fractures and that further evaluation of this protocol in live trauma patients is warranted. However, because no ndisplaced fractures were not routinely detected using reformatted coronal images, physical examination and clinical suspicion will still also remain necessary to determine the need fur further imaging.