在临床常规中,超低剂量计算机断层扫描能可靠地诊断和分类颌面部骨折吗?

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Imaging Science in Dentistry Pub Date : 2023-03-01 DOI:10.5624/isd.20220190
Gerlig Widmann, Marcel Dangl, Elisa Lutz, Bernhard Fleckenstein, Vincent Offermanns, Eva-Maria Gassner, Wolfgang Puelacher, Lukas Salbrechter
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摘要

目的:颌面部创伤主要影响20至40岁的年轻人。虽然放射防护是法律要求,但在临床常规中仍未充分利用计算机断层扫描(CT)中减少剂量的重大潜力。本研究的目的是评估使用超低剂量CT是否可以可靠地检测和分类颌面部骨折。材料与方法:采用AOCOIAC软件对123例颌面部骨折临床病例的CT图像进行分类,并与后处理图像的相应结果进行比较。第一组,97例孤立性面部创伤患者,不同剂量水平的治疗前CT图像(体积CT剂量指数:超低剂量,2.6 mGy;结果:两组超低剂量CT对骨折分型无临床相关影响。第2组14例患者的分类码差异较小,直接对比后差异不再明显。结论:超低剂量CT对颌面部骨折的诊断和分型具有较好的指导意义。这些结果可能导致对当前参考剂量水平进行实质性的重新考虑。
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Can ultra-low-dose computed tomography reliably diagnose and classify maxillofacial fractures in the clinical routine?

Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT.

Materials and methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated.

Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other.

Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

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来源期刊
Imaging Science in Dentistry
Imaging Science in Dentistry DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
2.90
自引率
11.10%
发文量
42
期刊最新文献
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