Kim Duk Ho, Choi Yoon Hee, Yun Seong Jong, Lee Sun Hwa
Department of Emergency Medicine, Ewha Womans University Hospital, Seoul, Korea.
Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Cheongwon, Korea.
Clin Exp Emerg Med. 2018 Jun;5(2):107-112. doi: 10.15441/ceem.17.223. Epub 2018 Jun 29.
Most patients with head trauma require brain computed tomography (CT) in the emergency department. However, the requirement for facial CT remains controversial. The aim of this study was to evaluate the diagnostic value of brain CT alone for detection of facial fractures and its ability to determine the requirement for additional facial CT.
This retrospective multicenter study was conducted in two tertiary hospitals in Seoul, Republic of Korea, between January 2014 and December 2015. Data were collected from the medical records of adult patients (aged over 18 years) who had undergone both brain and facial CT on the same day as their presentation to the emergency department with blunt trauma to the head and face. The same radiologist analyzed all brain and facial CT images.
Eight hundred and sixty patients (668 men, 192 women; mean age 48.60±18.2 years) were identified to have had facial fractures. There was a statistically significant predominance of men but not of any particular age group. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of brain CT were 83.72%, 98.87%, 97.17%, 92.92%, and 94.08%, respectively.
These findings suggest that brain CT has high diagnostic value for detection of upper facial bone fractures with high accuracy and can aid emergency physicians when determining the requirement for additional facial CT.
大多数头部外伤患者在急诊科需要进行脑部计算机断层扫描（CT）。然而，对面部CT的需求仍存在争议。本研究的目的是评估单独脑部CT对检测面部骨折的诊断价值及其确定是否需要额外进行面部CT的能力。
本回顾性多中心研究于2014年1月至2015年12月在韩国首尔的两家三级医院进行。数据收集自成年患者（年龄超过18岁）的医疗记录，这些患者在因头部和面部钝器伤就诊急诊科当天同时接受了脑部和面部CT检查。同一位放射科医生分析了所有脑部和面部CT图像。
确定有860例患者（668例男性，192例女性；平均年龄48.60±18.2岁）发生了面部骨折。男性在统计学上占显著优势，但不存在任何特定年龄组的优势。脑部CT的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为83.72%、98.87%、97.17%、92.92%和94.08%。
这些发现表明，脑部CT对检测上颌面部骨折具有较高的诊断价值，准确性高，并且在确定是否需要额外进行面部CT时可帮助急诊医生。
