Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms

• Published in: European radiology Vol. 19; no. 10; pp. 2416 - 2424
• Main Authors: Ringl, Helmut, Schernthaner, Ruediger, Philipp, Marcel O., Metz-Schimmerl, Sylvia, Czerny, Christian, Weber, Michael, Gäbler, Christian, Steiner-Ringl, Andrea, Peloschek, Philipp, Herold, Christian J., Schima, Wolfgang
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.10.2009; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Child; Diagnostic Radiology; Emergency Radiology; Female; Humans; Imaging; Imaging, Three-Dimensional - methods; Internal Medicine; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Radiographic Image Enhancement - methods; Radiographic Image Interpretation, Computer-Assisted - methods; Radiology; Reproducibility of Results; Sensitivity and Specificity; Skull Base - diagnostic imaging; Skull Base - injuries; Skull Fractures - diagnostic imaging; Tomography, X-Ray Computed - methods; Ultrasound; Young Adult; Fracture; 3D reconstruction; Computed tomography; Skull base; Trauma; Maximum intensity projection (MIP)
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-009-1435-1

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.