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Computed tomography and thin-section tomography in facial trauma.

D L Kreipke, J J Moss, J M Franco

    AJR. American Journal of Roentgenology
    |May 1, 1984
    PubMed
    Summary

    Computed tomography (CT) and pluridirectional tomography (PT) effectively detect facial fractures. Imaging in two planes, including coronal, enhances accuracy for both CT and PT in diagnosing maxillofacial trauma.

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    Area of Science:

    • Radiology
    • Medical Imaging
    • Maxillofacial Surgery

    Background:

    • Facial fractures are common injuries resulting from maxillofacial trauma.
    • Accurate detection and classification of facial fractures are crucial for effective treatment.
    • Radiographic methods, including plain radiography, tomography, and computed tomography, are used for diagnosis.

    Purpose of the Study:

    • To assess the efficacy of radiographic methods in detecting and classifying facial fractures.
    • To compare pluridirectional tomography (PT) and computed tomography (CT) in demonstrating fractures.
    • To evaluate the effectiveness of combining plain films with specialized imaging for fracture classification.

    Main Methods:

    • Thirty-one patients with maxillofacial trauma were studied.

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  • Imaging modalities included plain radiography, coronal and lateral pluridirectional tomography (PT), and axial and direct coronal computed tomography (CT).
  • Analyses were performed using two projections and single projections for PT and CT to account for institutional limitations.

    • Main Results:

    • With two projections, CT demonstrated more fractured surfaces (168 vs. 156) and better fracture classification with plain films (48 vs. 43) compared to PT.
    • With single projections, PT surpassed CT in showing fractures (137 vs. 124) and classifying them (42 vs. 40).
    • Failures occurred when the imaging plane was parallel or oblique to the structure (e.g., axial CT for orbital floor, coronal PT for anterior maxillary sinus wall).

    Conclusions:

    • Imaging in two planes, incorporating the coronal plane, is essential for optimal fracture detection accuracy with CT, PT, or both.
    • Computed tomography (CT) generally offers superior display of soft-tissue abnormalities.
    • Both CT and PT have limitations depending on the specific facial structures and imaging planes used.