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Predictive Value of Air Bubble and Meniscus Signs on Routine Trauma Head CT for Nondisplaced Temporal Bone Fractures
Omar Azrak1, Aleeshah Nasir2, Bilal Battal2
1From the Department of Radiology (O.A., B.B., S.-C.H., C.Z.), Psychiatry (A.N.), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA and HCA Florida Oak Hill Hospital (O.A.), Brooksville, FL, USA. Omar_azrak@med.unc.edu.
The meniscus and air bubble signs on standard head CTs are effective indicators for detecting subtle, nondisplaced temporal bone fractures in trauma patients. These findings can help identify patients who may benefit from further high-resolution imaging.
Area of Science:
- Radiology
- Neuroradiology
- Emergency Medicine
Background:
- Temporal bone fractures are common in head trauma patients.
- Nondisplaced fractures are often missed on routine head CT scans.
Purpose of the Study:
- To evaluate the diagnostic utility of the "meniscus" and "air bubble" signs on standard trauma head CTs.
- To assess the predictive value of these signs for nondisplaced temporal bone fractures.
Main Methods:
- Retrospective review of 167 head trauma patients.
- Evaluation of standard head CTs for meniscus/air bubble signs and opacification.
- Comparison with high-resolution temporal bone CT as the reference standard.
Main Results:
- Nondisplaced temporal bone fractures were present in 61.7% of patients.
- Meniscus and air bubble signs were significantly more frequent in patients with fractures (p<0.0001).
- The meniscus sign demonstrated high specificity (95.3%), while combined signs improved sensitivity (80.6%).
Conclusions:
- The air bubble and meniscus signs are strong indicators of nondisplaced temporal bone fractures on routine head CT.
- These signs may prompt further dedicated temporal bone CT for earlier fracture recognition.
