Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Clin Oral Investig. 2023 Mar;27(3):1227-1233. doi: 10.1007/s00784-022-04736-y. Epub 2022 Oct 8.
To assess and compare the diagnostic performance of CT-like images based on a three- dimensional (3D) T1-weighted spoiled gradient-echo sequence (3D T1 GRE) with CT in patients with acute traumatic fractures of the mandible.
Subjects with acute mandibular fractures diagnosed on conventional CT were prospectively recruited and received an additional 3 T MRI with a CT-like 3D T1 GRE sequence. The images were assessed by two radiologists with regard to fracture localization, degree of dislocation, and number of fragments. Bone to soft tissue contrast, diagnostic confidence, artifacts, and overall image quality were rated using a five-point Likert-scale. Agreement of measurements was assessed using an independent t-test.
Fourteen subjects and 22 fracture sites were included (26 ± 3.9 years; 4 females, 10 males). All traumatic fractures were accurately detected on CT-like MRI (n = 22, κ 1.00 (95% CI 1.00-1.00)). There was no statistically significant difference in the assessment of the fracture dislocation (axial mean difference (MD) 0.06 mm, p = 0.93, coronal MD, 0.08 mm, p = 0.89 and sagittal MD, 0.04 mm, p = 0.96). The agreement for the fracture classification as well as the inter- and intra-rater agreement was excellent (range κ 0.92-0.98 (95% CI 0.96-0.99)).
Assessment of mandibular fractures was feasible and accurate using CT-like MRI based on a 3D T1 GRE sequence and is comparable to conventional CT.
For the assessment of acute mandibular fractures, CT-like MRI might become a useful alternative to CT in order to reduce radiation exposure particularly in young patients.
评估和比较基于三维（3D）T1 加权扰相梯度回波序列（3D T1 GRE）的 CT 样图像与 CT 在急性创伤性下颌骨骨折患者中的诊断性能。
前瞻性招募了经常规 CT 诊断为急性下颌骨骨折的患者，并接受了另外的 3T MRI 检查，使用 CT 样 3D T1 GRE 序列。两名放射科医生评估了骨折的定位、脱位程度和碎片数量。使用 5 分李克特量表评估骨与软组织对比、诊断信心、伪影和整体图像质量。使用独立 t 检验评估测量值的一致性。
纳入 14 名患者和 22 个骨折部位（26 ± 3.9 岁；女性 4 名，男性 10 名）。所有外伤性骨折均在 CT 样 MRI 上准确检出（n = 22，κ = 1.00（95%CI 1.00-1.00））。骨折脱位的评估无统计学差异（轴向平均差异（MD）0.06mm，p = 0.93，冠状 MD 0.08mm，p = 0.89 和矢状 MD 0.04mm，p = 0.96）。骨折分类的评估以及组内和组间的一致性均为优秀（范围 κ 0.92-0.98（95%CI 0.96-0.99））。
使用基于 3D T1 GRE 序列的 CT 样 MRI 对下颌骨骨折进行评估是可行且准确的，与常规 CT 相当。
对于急性下颌骨骨折的评估，CT 样 MRI 可能成为 CT 的有用替代方法，以减少特别是在年轻患者中的辐射暴露。
