CT and MRI post-processing reconstructions in the maxillo-facial trauma.

摘要

Background:The aim of the study is to evaluate the reliability of CT and MR imaging and their post-processing reconstructions in the cases of facial trauma.Material/Methods: CT studies were performed in 34 patients:13 suspected of sinus fractures,20 with orbital fractures and 1 with broken supraorbital bone fragment.MR imaging was also performed in 16 of these patients.The CT data were reconstructed in the 2D and 3D mode.The CT and MR images were digitally fused using an own program.The CT and MR images,their reconstructions and their fusion were evaluated according to the quality of visualization of a pathological lesions.Surgery was the method of reference.Results: The reconstructed CT images allowed to recognize properly maxillary-oral fenestration in 5 cases. In 20 patients with orbital fracture,CT 3D reformations visualized well the morphology of the fissure.In 13 of these patients,the small bone fragments and orbital soft tissues prolapsed towards the maxillary sinus were depicted.Among the 16 patients who underwent MR examination, in 6 cases we revealed dislocation of the inferior rectus muscle towards the sinus,whereas in 9 cases MR images clearly excluded this pathology.In 1 patient,the digitally fused CT/MR images allowed to determine the actualposition of small bone fragment within the muscle. In 1 patient with broken supraorbital bone fragment,evaluation of the 3D model allowed to exclude communication with intracranial space.In the next 8 patients with maxillo-zygomatic injures, the CT reconstructions did not support the diagnosis.The surgery correlated well with the post-processing CT and CT/MR fused images,contrary to the original CT ones which often were diagnostically insufficient.Conclusions: Spiral CT 2D and 3D-reconstructed images of the face allow to depict clearly the anatomical spatial relationships and the position,course and displacement of fractured fragments;thus,they support the surgery.The MR images of these patients reveal soft tissues clearly. The digital fusion of CT/MR data unifies both bony and soft tissues on one image.