Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.
Skeletal Radiol. 2010 Nov;39(11):1087-95. doi: 10.1007/s00256-010-0911-7. Epub 2010 Mar 12.
To compare the diagnostic accuracy and radiation exposure of cone beam computed tomography (CBCT) and multislice computed tomography (MSCT) in the evaluation of finger fractures.
In a 3-year period, 57 consecutive patients with post-traumatic fractures of the metacarpal-phalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints with involvement of the articular surface were studied by means of CBCT and MSCT. Student's t test was used to compare CBCT and MSCT accuracy in evaluating the percentage of joint surface involvement and in detecting bone fragments. The average tissue-absorbed doses of CBCT and MSCT were also compared. A value of p < 0.05 was considered statistically significant. Inter-observer agreement was calculated.
In all cases, CBCT allowed the percentage of articular involvement to be correctly depicted compared with MSCT, showing 100% sensitivity and specificity (p < 0.001). A total of 103 bone fragments were depicted on MSCT (mean 3.8 per patient, range 1-23). CBCT indicated 92 out of 103 fragments (89.3%) compared with MSCT (mean diameter of missed fragments 0.9 mm, range 0.6-1.3 mm), with no statistically significant difference between CBCT and MSCT (p < 0.025). Multislice CT radiation exposure was significantly higher than that of CBCT (0.18 mSv vs 0.06 mSv, p < 0.0025). Inter-observer agreement was good (overall κ = 0.89-0.96).
Cone beam CT may be considered a valuable imaging tool in the preoperative assessment of finger fractures, when MSCT is not available.
比较锥形束 CT（CBCT）和多层 CT（MSCT）在评估手指骨折中的诊断准确性和辐射暴露。
在 3 年期间，对 57 例累及关节面的掌指（MCP）、近指间（PIP）和远指间（DIP）关节外伤性骨折的连续患者进行了 CBCT 和 MSCT 检查。采用 Student's t 检验比较 CBCT 和 MSCT 在评估关节面受累百分比和检测骨碎片方面的准确性。还比较了 CBCT 和 MSCT 的平均组织吸收剂量。p<0.05 被认为具有统计学意义。计算了观察者间的一致性。
在所有病例中，CBCT 均能正确显示关节受累百分比，与 MSCT 相比，具有 100%的敏感性和特异性（p<0.001）。MSCT 共显示 103 块骨碎片（平均每位患者 3.8 块，范围 1-23 块）。CBCT 显示 92 块中的 103 块（89.3%）与 MSCT 相比（漏检骨碎片的平均直径为 0.9 毫米，范围 0.6-1.3 毫米），CBCT 与 MSCT 之间无统计学差异（p<0.025）。MSCT 的辐射暴露明显高于 CBCT（0.18 毫希弗 vs 0.06 毫希弗，p<0.0025）。观察者间的一致性良好（总体 κ 值为 0.89-0.96）。
当 MSCT 不可用时，CBCT 可作为手指骨折术前评估的一种有价值的成像工具。
