title: 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.
  
  
  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.
authors.affiliation: Department of Radiology, College of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Denise Takehana Dos
authors.initials: DT
authors.lastname: Santos
authors.forename: Jefferson Xavier
authors.initials: JX
authors.lastname: Oliveira
authors.forename: Michael Walter
authors.initials: MW
authors.lastname: Vannier
authors.forename: Marcelo Gusmão Paraíso
authors.initials: MG
authors.lastname: Cavalcanti