Skull fractures in pediatric patients on computerized tomogram: comparison between routing bone window images and 3D volume-rendered images

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• 作者：Sathish Kumar Dundamadappa ; Senthur Thangasamy ; Nancy Resteghini…
• 关键词：Skull fracture ; CT ; 3D volume rendered imaging
• 刊名：Emergency Radiology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：22
• 期：4
• 页码：367-372
• 全文大小：905 KB
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• 作者单位：Sathish Kumar Dundamadappa (1)
  Senthur Thangasamy (2)
  Nancy Resteghini (1)
  Srinivasan Vedantham (1)
  Andrew Chen (1)
  Deepak Takhtani (1)
  
  1. University of Massachusetts, 55 Lake Avenue North, Worcester, MA, 01655, USA
  2. University Hospital Coventry and Warwickshire, Coventry, UK
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Emergency Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1438-1435

文摘

Skull fracture is a common finding following head trauma. It has a prognostic significance and its presence points to severe trauma. Additionally, there is a greater possibility of detecting associated small underlying extra-axial hematomas and subtle injuries to the brain parenchyma. In pediatric patients, the presence of multiple open sutures often makes fracture evaluation challenging. In our experience, 3D volume (3DV)-rendered CT images complement routine axial bone window (RBW) images in detection and characterization of fractures. This is a multi-reader, multi-case, paired retrospective study to compare the sensitivity and specificity of RBW and 3DV images in detection of calvarial fractures in pediatric patients. A total of 60 cases (22 with fractures and 38 without) were analyzed. Two experienced neuroradiologists and a radiology trainee were the readers of the study. For all readers, the sensitivity was not statistically different between the RBW and the 3DV interpretations. For each reader, there was a statistically significant difference in the interpretation times between the RBW and the 3DV viewing formats. A greater number of sutural diastasis was identified on 3DV. We propose that 3DV images should be part of routine head trauma imaging, especially in the pediatric age group. It requires minimal post-processing time and no additional radiation. Furthermore, 3DV images help in reducing the interpretation time and also enhance the ability of the radiologist to characterize the calvarial fractures.