Computed tomography imaging strategies and perspectives in orbital fractures

Abstract

Objective:The objective of this study was to demonstrate the sensitivity and specificity of multislice computed tomography (CT) for diagnosis of orbital fractures following different protocols, using an independent workstation.Materials and methods:CT images of 36 patients with maxillofacial fractures (symptomatic to orbit region) who were submitted to multislice CT scanning were analyzed, retrospectively. The images were interpreted based on 5 protocols, using an independent workstation: 1) axial (original images); 2) multiplanar reconstruction (MPR); 3) 3D images; 4) association of axial/MPR/3D images and 5) coronal images. The evaluated anatomical sites were divided according to the orbital walls: lateral (with or without zygomatic frontal process fracture); medial; superior (roof) and inferior (anterior, medial). The collected data were analyzed statistically using a validity test (Youden's J index; p<0.05). The clinical and/or surgical findings (medical records) were considered as the gold standard to corroborate the diagnosis of the anatomical localization of the orbital fracture.Results:3D-CT scanning presented sensitivity of 78.9%, which was not superior to that of MPR (84.0%), axial/MPR/3D (90.5%) and coronal images (86.1%). On the other hand, the diagnostic value of axial images was considered limited for orbital fractures region, with sensitivity of 44.2%.Conclusions:Except for the axial images, which presented a low sensitivity, all methods evaluated in this study showed high specificity and sensitivity for the diagnosis of orbital fractures according to the proposed methodology. This protocol can add valuable information to the diagnosis of fractures using the association of axial/MPR/3D with multislice CT.

Validity of computed tomography in diagnosing midfacial fractures

“…Previous studies of orbital fractures imaging diagnosis showed that the association of 2D-Axial images and 3D-CT reconstructions has a sensitivity of 90.5%. This is reduced to 86.1% when associating 2D-Coronal images and 3D-CT 26 . These authors did not describe the 2D-Sagittal plane.…”

Computed Tomography (CT) Protocols Associated with Cardiac and Bone Single-Photon Emission Computed Tomography/CT (SPECT/CT) in Korea

“…These algorithms can improve the spatial resolution of CT images in skeletal studies. A smaller field of view with thinner slices can produce better sensitivity and diagnostic accuracy of small lesions in the foot, wrist, and orbital cavities [46][47][48]. A balance between the change in slice thickness and image noise should be considered when devising optimized protocols for these applications [49].…”

Surgical Outcome of Blowout Fractures of Floor of Orbit: A Case Series of 5 Patients

“…Orbital imaging in suspected cases by X-ray, CT scan or MRI help to confirm the diagnosis. Coronal and axial CT scans are adequate for visualization of orbital fractures [12]. MRI may be rarely indicated in the later stages for diagnosis of muscular fibrosis.…”