A Study of Craniofacial Fractures Using Computed Tomography

Abstract

Complex craniofacial injuries are encountered among both road traffic accident and other trumatic cases. Computed tomography is a necessary and effective tool for the evaluation and treatment of these injuries. The aim of this research was to study craniofacial fractures using computed tomography. Specifically to identify visible fracture in CT, to evaluate craniofacial fractures between axial cut and 3DCT, to evaluate craniofacial fractures between sagittal cut and 3DCT and to evaluate craniofacial fractures between coronal cut and 3DCT. This study compared between different CT planes and 3DCT in different types of fractures and in different craniofacial bone fractures and then found out better reconstruction for visualization of craniofacial fractures. This descriptive study was conducted in Khartoum-Sudan, data were collected from 200 adult patients clinically diagnosed as having fracture to craniofacial bone and who had undergone craniofacil, CT scan was perform with TOSHIBA 16 slices. All scans were unenhanced. Standard protocols were basic (1:1 pitch, 120 –140 kV, and 175–250 mA). All images were obtained in axial with thin slice 3-5mm and reformat images wre obtain in coronal, sagittal and 3D. The radiologist analyzed all cranifacial CT images to determine which image plane and types demonstrates craniofacil fractures The study showed that fracture type better seen in 3D images in traumatic patients was depressed fracture appeared in 3DCT (118) (100%), linear fracture appeared in 3DCT (52) (63.4%) with p value (0.00) that mean there is significance relation . also In evaluation the difference between fracture type and axial plane in traumatic patients was found that depressed fracture appeared in axial plane (106) (89.8%), linear fracture appeared in axial plane (75) (91.4%) with p value (0.448) that mean there is insignificance relation. In comparison between axial plane and 3DCT we found that there was (155) (85.6%) craniofacial fractures appeared in both with p value (0.312) that mean there is insignificance relation, but in sagittal and coronal cut there was (147) (93%) with p value (0.00) and (142)(94.6%) with p value (0.00) respectively that mean there was significance relation. Based on results of this study and previous study conclude that 3D reconstruction may offer a problem solving option, 3D imaging can provide useful information to both radiologist and surgeon in cases of severe facial trauma. The study concluded the study of craniofacial fracture, multiplannar reconstrction and 3D increase the effectiveness of visibility and extend of cranifacial fractures. A study recommended that 3DCT should be added as a routine imaging for head injury patients, in future studies researcher should use larger sample size for better evaluation; specification of bone under study will ease up findings and data acquisition.