Finger fractures imaging: accuracy of cone-beam computed tomography and multislice computed tomography.
OBJECTIVE
To compare the diagnostic accuracy and radiation exposure of cone beam computed tomography (CBCT) and multislice computed tomography (MSCT) in the evaluation of finger fractures.


METHODS
In a 3-year period, 57 consecutive patients with post-traumatic fractures of the metacarpal-phalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints with involvement of the articular surface were studied by means of CBCT and MSCT. Student's t test was used to compare CBCT and MSCT accuracy in evaluating the percentage of joint surface involvement and in detecting bone fragments. The average tissue-absorbed doses of CBCT and MSCT were also compared. A value of p < 0.05 was considered statistically significant. Inter-observer agreement was calculated.


RESULTS
In all cases, CBCT allowed the percentage of articular involvement to be correctly depicted compared with MSCT, showing 100% sensitivity and specificity (p < 0.001). A total of 103 bone fragments were depicted on MSCT (mean 3.8 per patient, range 1-23). CBCT indicated 92 out of 103 fragments (89.3%) compared with MSCT (mean diameter of missed fragments 0.9 mm, range 0.6-1.3 mm), with no statistically significant difference between CBCT and MSCT (p < 0.025). Multislice CT radiation exposure was significantly higher than that of CBCT (0.18 mSv vs 0.06 mSv, p < 0.0025). Inter-observer agreement was good (overall κ = 0.89-0.96).


CONCLUSIONS
Cone beam CT may be considered a valuable imaging tool in the preoperative assessment of finger fractures, when MSCT is not available.
Faccioli
Niccolò
N
Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.
Foti
Giovanni
G
Barillari
Marco
M
Atzei
Andrea
A
Mucelli
Roberto Pozzi
RP
D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging*; D050278:Finger Phalanges / Q000000981:diagnostic imaging* / Q000293:injuries*; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult