Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.
Department of Plastics, Hand and Faciomaxillary surgery, Alfred Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2021 May;91(5):962-968. doi: 10.1111/ans.16848. Epub 2021 Apr 12.
The authors aimed to examine the differences in CT facial bone interpretation by the faciomaxillary surgeon and the radiologist, in order to improve communication gaps and subsequently, the quality and consistency of patient care.
This study was conducted at a level I tertiary trauma centre. Patients with facial trauma who were referred to the faciomaxillary unit following a facial CT examination from August 2017 to September 2018 were eligible for inclusion. The inclusion period was extended to 5 years for panfacial trauma patients. All consecutive patients that fulfilled the study inclusion criteria for each type of injury were included in the study (a total of 120 patients assigned to the following six categories: orbits, skull and skull base, zygomaticomaxillary complex, Le Fort pattern, mandible and pan-facial fractures). Faciomaxillary surgeons, blinded to the radiology report, were asked to provide a verbal description of the fractures. The surgical interpretation was compared to the radiology report and further analysed.
Of the 120 cases, the same fractures were reported in 43 cases (35.8%). Both types of specialists noted the predominant and clinically relevant fractures in 106 cases (88.3%). The reports did not match in 14 cases (11.7%) and different terminology was used in 76 cases (63.3%), with agreement in 25% (95% CI: 18-34%), partial agreement in 11.7% (95% CI: 5.9-17.4%) and no agreement in 63.3% (95% CI: 54.7-72.0%) cases.
Radiologists and faciomaxillary surgeons frequently differ in their assessment of facial fractures.
作者旨在研究颌面外科医生和放射科医生对面部 CT 骨解读的差异，以减少沟通障碍，进而提高患者护理的质量和一致性。
该研究在一家一级创伤中心进行。2017 年 8 月至 2018 年 9 月，在对患者进行面部 CT 检查后，将面部创伤患者转诊至颌面外科。对于全颜面创伤患者，纳入时间延长至 5 年。符合每种损伤类型的所有连续患者均被纳入研究（总共 120 名患者分为以下六类：眼眶、颅骨和颅底、颧骨复合体、Le Fort 型、下颌骨和全颜面骨折）。颌面外科医生在不了解放射学报告的情况下，被要求对面部骨折进行口头描述。将手术解读与放射学报告进行比较，并进一步分析。
在 120 例病例中，43 例（35.8%）报告了相同的骨折。两种类型的专家都在 106 例（88.3%）中记录了主要和临床上相关的骨折。在 14 例（11.7%）中报告不匹配，在 76 例（63.3%）中使用了不同的术语，一致性为 25%（95%CI：18-34%），部分一致性为 11.7%（95%CI：5.9-17.4%），无一致性为 63.3%（95%CI：54.7-72.0%）。
放射科医生和颌面外科医生对面部骨折的评估经常存在差异。
