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Aim: This study aimed to evaluate
sensitivity of multi planer and 3D of CT image in patients with craniofacial
bone fractures.
Methodology: Descriptive analytical study was
conducted. Patients referred for CT skull examination after trauma and
diagnosed with fracture.
Results: In this study sample size was
(150 patients) and frequency of male was 105 with percent 70%, female was 45
with percent 30%.
Most bone fracture appear in 3DCT was facial, parietal and temporal
with frequency (30), (29), (22), respectively.
Most bone fracture appear in axial cut in MPR was facial, parietal and
temporal with frequency (30), (28), (22), respectively.
Most bone fracture appear in sagittal cut in MPR was facial, parietal
and temporal with frequency (32), (29), (15), respectively.
Most bone fracture appear in coronal cut in MPR was parietal, facial
and temporal with frequency (29), (23), (19), respectively.
Conclusion: In evaluation the
difference between MPR and 3D images to determining fractures in traumatic
patients we found that any depressed fracture appeared in MPR will be clearly
appeared in 3DCT, but linear fracture depend on MPR appearance.
Recommendations: Specification of bone under study
will ease up findings and data acquisition.
Keywords: 3DCT, MPR
INTRODUCTION
A CT scan makes use of computer-processed
combinations of many X-ray images taken from different angles to produce
cross-sectional (tomographic) images (virtual “slices”) of specific areas of a
scanned object, allowing the user to see inside the object without cutting [1].
Digital geometry processing is used to generate
a three-dimensional image of the inside of the object from a large series of
two-dimensional radiographic images taken around a single axis of rotation.
Medical imaging is the most common application of X-ray CT. Its cross-sectional
images are used for diagnostic and therapeutic purposes in various medical
disciplines. The rest of this article discusses medical-imaging X-ray CT;
industrial applications of X-ray CT are discussed at industrial computed
tomography scanning [2].
3D
imaging
Three-dimensional rendering could
not have been developed without advances in computer hardware, software and
display technology. Progress has been incremental and often limited by the
state of the art in any one of these technologies on which development depends.
Despite these constraints, SSD and MIP have remained functional by making use
of only about 10% of the available CT data and implementing very simple
rendering schemes [3], although this compromise limits the accuracy of rendered
images. Volume rendering incorporates the entire data set into a 3D image [4,5].
Initially, image processing and display was very time consuming: Several hours
were required to render an animation loop for viewing. However, recent advances
in computer hardware have made volume rendering a practical,
LITERATURE REVIEW
Imaging of
maxillofacial and skull base trauma
In this study they consider explaining that
CT is image of choice for suspected craniofacial fracture and after they
finished decided that analysis with MIPs is a useful addition to obligatory
MPRs [6].
A study of
diagnostic performance of CT, MPR and 3DCT imaging in maxillofacial trauma
In this study they to elaborate that CT
imaging of complex maxillofacial fractures is common practice now. Sensitivity
and specificity were calculated to measure observer performance. It was found
that 3D and CT had a similar performance in fracture detection and both were markedly
better than MPR. It was concluded that CT and 3D are comparable in detecting
mid-facial fractures and both are superior to MPR. 3D reconstructions are
superior for localization of complex fractures involving multiple planes [7].
A study of validity of multi-slice
computerized tomography for diagnosis of maxillofacial fractures using an
independent workstation.
In this study they explain the CT
images of 36 patients with maxillofacial fractures (symptomatic to orbit
region). The images were interpreted based on 5 protocols, using an independent
workstation. 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 multi-slice CT [8].
MATERIALS AND
METHODS
Materials
Study design: Descriptive analytical study was
conducted.
Study area and
duration: The
study was conducted in Khartoum state, included hospitals:
·
Ibrahim Malik Hospital
·
Yastabshiroon Al-Khartoum Hospital
·
Altamayoz for Emergency
·
Al Zaytuona Hospital
Study duration: From 2017-June 2019
Study population: Patients referred for CT skull
examination after trauma and diagnosed with fracture.
Sample size and
sampling: 150
patients admitted to all previous hospitals.
Inclusion criteria: Traumatic patient with a
diagnosed craniofacial fracture under CT scan.
Exclusion criteria: Craniofacial CT scan diagnosed as
normal.
Variable under
study: Gender,
age side of fracture, area of fracture, type of fracture. Visualization in MPR
and 3D.
Methods
CT technique of
craniofacial imaging:
Patient position: That patient lies supine on the
examination couch with their head within the head holder. The head is adjusted
so that the entry papillary line is parallel to the couch and the head is
straight. The patient is positioned so that the longitudinal alignment light
lies in the midline and the horizontal alignment light passes through the
nasion. Straps and foam pads are used for immobilization.
Equipment:
·
Head holder
·
Immobilization foam pads
Data collection
tools and techniques: All data was collected from traumatic patients referred for
craniofacial CT examination and then we used SPSS version 16 to analyze data
and represented in tables, pie chart and graphs.
Methods of
measurements:
Fractures were visualized under (sagittal, axial and coronal) MPR and 3D
images.
RESULTS AND DISCUSSION
In this study sample size was (150 patients)
and frequency of male was 105 with percent 70%, female was 45 with percent 30% (Table 1 and Figure 1).
Table 3 shows frequency of bone fracture
and the most bone fractured was fracture of facial bone and parietal bone
fracture with equal percent (22.7%) and then temporal bone (14.7%) frontal bone
(10.7%), occipital bone (10.7%), base of skull (8%), temporal + parietal + frontal
(6%), facial + base of skull (1.3%) parietal + frontal (1.3%), parietal +
frontal + facial (0.7%), temporal + frontal (0.7%), temporal + parietal (0.7%).
According to fracture type Table 4 and Figure 2 we found that
frequency of depressed fracture (90) with percent 60% and frequency of linear
fracture (60) with percent 40%.
Tables 5-9 and Figures 3-8 shows fractures that appear in 3DCT from total of
150 patient s and the result show that there is 127 with percent 84.7 appear in
CT.
Frequency of most bone fractures that appear
was facial bone (31), parietal bone (29) and then temporal bone (21) (Table 10).
Table 11 shows the relation between type of fracture and 3DCT and result was that total of 90 depressed fractures appear in 3DCT, but linear fracture with total (60) there was only 37 appear in 3DCT.
When we compared MPR with 3DCT (Tables 12 and 13) the result was
similar in depressed fracture appearance in axial and sagittal which was (81
out of 90) in both. But in linear fracture type in axial (57 out of 60) and in
sagittal (34 out of 60).
Tables 14-17 we compared MPR with 3DCT and
result was there is (117 out of 138) appear in axial and 3DCT and (109 out of
115) appear in sagittal and (105 out of 110) appear in coronal.
This result match with most literature.
Most bone fracture appears in 3DCT (Table 18) was facial, parietal and
temporal with frequency (30), (29), (22), respectively.
Most bone fracture appear in axial cut in MPR
(Table 19) was facial, parietal and
temporal with frequency (30), (28), (22), respectively.
Most bone fracture appear in sagittal cut in
MPR (Table 20) was facial, parietal
and temporal with frequency (32), (29), (15), respectively.
Most bone fracture appear in coronal cut in
MPR was parietal, facial and temporal with frequency (29), (23), (19),
respectively.
CONCLUSION
This study concludes that the visible
fractures under 3D images were facial, parietal and temporal, respectively.
In evaluation the difference between MPR and
3D images to determining fractures in traumatic patients we found that any
depressed fracture appeared in MPR will be clearly appeared in 3DCT,but linear
fracture depend on MPR appearance.
RECOMMENDATIONS
About 3DCT should be added as a routine
imaging.
Specification of bone under study will ease
up findings and data acquisition.
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Retrieved on January 26, 2007.
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