Hooper Tayla, Eccles Grace, Milliken Talia, Mathieu-Burry Josephine R, Reed Warren
Discipline of Medical Radiation Sciences, the University of Sydney, Lidcombe, Australia.
J Med Radiat Sci. 2019 Jun;66(2):122-132. doi: 10.1002/jmrs.319. Epub 2019 Feb 1.
Trauma to the facial area accounts for a significant number of admissions to the emergency department. Diagnostic imaging is almost always required, and is critical in determining patient management. Multi-detector computed tomography (MDCT) appears consistently in the literature as the gold-standard imaging modality for facial bones, but results in a high radiation dose to the patient. This makes the application and advancement of dose reduction and dose optimisation methods vital. This narrative review presents a critical analysis of the literature concerning diagnostic imaging of facial bone trauma, with an emphasis on dose reduction methods for MDCT. Databases including Pubmed, Medline, Web of Science and Scopus were used to investigate this topic, with the key words: facial bone trauma, computed tomography (CT) imaging and dose reduction. Exclusion criteria included studies on nasal bone fracturing, dental imaging, elective surgeries and paediatric imaging. The literature shows overwhelming support for MDCT, given its accuracy, efficiency and ease of operation. Noise reducing reconstruction algorithms show promise as a successful method of dose reduction in facial bone imaging. Investigations of more innovative techniques also appear within the literature, including diagnostic cone-beam CT (CBCT), intraoperative CBCT and dual-source CT (DSCT), but further research is required to confirm their clinical value.
面部创伤导致大量患者进入急诊科就诊。几乎总是需要进行诊断性成像，这对于确定患者的治疗方案至关重要。多排螺旋计算机断层扫描（MDCT）在文献中一直被视为面部骨骼成像的金标准，但会给患者带来较高的辐射剂量。这使得降低剂量和优化剂量方法的应用与发展至关重要。本叙述性综述对有关面部骨创伤诊断性成像的文献进行了批判性分析，重点关注MDCT的剂量降低方法。使用包括PubMed、Medline、科学引文索引和Scopus在内的数据库对该主题进行研究，关键词为：面部骨创伤、计算机断层扫描（CT）成像和剂量降低。排除标准包括鼻骨骨折研究、牙科成像、择期手术和儿科成像。鉴于MDCT的准确性、效率和操作简便性，文献显示其获得了压倒性的支持。降噪重建算法有望成为面部骨成像中成功的剂量降低方法。文献中也出现了对更创新技术的研究，包括诊断性锥形束CT（CBCT）、术中CBCT和双源CT（DSCT），但需要进一步研究以证实它们的临床价值。
