Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms.
The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection.
Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria. helmut.ringl@meduniwien.ac.at
Helmut
H
Ringl
Ruediger
R
Schernthaner
Marcel O
MO
Philipp
Sylvia
S
Metz-Schimmerl
Christian
C
Czerny
Michael
M
Weber
Christian
C
Gäbler
Andrea
A
Steiner-Ringl
Philipp
P
Peloschek
Christian J
CJ
Herold
Wolfgang
W
Schima
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019291:Skull Base / Q000000981:diagnostic imaging* / Q000293:injuries*; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult