基于黑骨和CT样MRI的口腔颌面创伤中骨折易发生区域的描绘。

Black bone and CT-like MRI-based delineation of fracture-prone regions in oral and maxillofacial trauma.

作者信息

Al-Haj Husain Adib, Kessler Peter, Lie Suen An Nynke, Drack Samuel, Burian Egon, Sandhu Sameena, Wagner Maximilian Eberhard Hermann, Stadlinger Bernd, Frauenfelder Thomas, Colacicco Giovanni, Spin-Neto Rubens, Essig Harald

机构信息

Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.

Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

出版信息

Oral Maxillofac Surg. 2025 Jul 28;29(1):136. doi: 10.1007/s10006-025-01431-6.

DOI:10.1007/s10006-025-01431-6

PMID:40719933

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12304013/

Abstract

PURPOSE

To assess the effectiveness and feasibility of MRI-based delineation of fracture-prone regions in the oral and maxillofacial region using Black Bone and CT-like MRI protocols optimized for dentomaxillofacial imaging with a dedicated 15-channel mandibular coil.

METHODS

In this prospective study, healthy volunteers underwent 3T MRI using five protocols: DESS, SPACE STIR, SPACE SPAIR, T1-VIBE Dixon, and UTE. Eight trauma-prone regions, including the nasal septum, orbit, naso-orbito-ethmoidal (NOE) complex, zygomaticomaxillary complex, Le Fort regions, mandible, condyle, and dentoalveolar complex, were assessed. Image quality, artifacts, anatomical delineation, and bone-to-soft-tissue contrast were rated on a five-point Likert scale by three independent observers. Descriptive statistics and inter-rater agreement (intraclass correlation coefficients (ICCs)) were calculated.

RESULTS

Sixteen participants (37.2 ± 12.9 years; 12 males, 4 females) were included, resulting in 80 MRI volumes and 640 regions for evaluation. UTE and VIBE-DIXON sequences achieved the highest ratings for image quality, artifact susceptibility, and anatomical delineation across most fracture-prone regions (ICC: 0.793-1; all p < 0.001). UTE excelled in visualizing NOE and Le Fort regions, while VIBE-DIXON performed best in mandibular and orbital imaging. Bone-to-soft-tissue contrast was highest in UTE and VIBE-DIXON, highlighting their diagnostic potential in simultaneous soft and hard tissue imaging. Inter-rater agreement was consistently high (ICC: 0.772-0.976; all p < 0.001).

CONCLUSION

Dedicated trauma-specific MRI protocols show promising potential as a radiation-free modality for maxillofacial trauma imaging, particularly in young adults and pediatric patients. The strengths of each protocol highlight the need for tailored sequence selection to optimize diagnostic accuracy and personalized care.

TRIAL REGISTRATION NUMBER

Swiss National Clinical Trials Portal: SNCTP000005246.

摘要

目的

使用针对牙颌面成像优化的黑骨成像和类CT MRI协议以及专用的15通道下颌线圈，评估基于MRI描绘口腔颌面部骨折易发生区域的有效性和可行性。

方法

在这项前瞻性研究中，健康志愿者使用五种协议接受3T MRI检查：DESS、SPACE STIR、SPACE SPAIR、T1-VIBE Dixon和UTE。评估了八个易发生创伤的区域，包括鼻中隔、眼眶、鼻眶筛（NOE）复合体、颧上颌复合体、Le Fort区域、下颌骨、髁突和牙槽复合体。由三名独立观察者根据五点李克特量表对图像质量、伪影、解剖结构描绘和骨与软组织对比度进行评分。计算描述性统计量和评分者间一致性（组内相关系数（ICC））。

结果

纳入了16名参与者（37.2±12.9岁；12名男性，4名女性），产生了80个MRI容积和640个区域用于评估。UTE和VIBE-DIXON序列在大多数骨折易发生区域的图像质量、伪影敏感性和解剖结构描绘方面获得了最高评分（ICC：0.793 - 1；所有p < 0.001）。UTE在可视化NOE和Le Fort区域方面表现出色，而VIBE-DIXON在下颌骨和眼眶成像中表现最佳。骨与软组织对比度在UTE和VIBE-DIXON中最高，突出了它们在同时进行软组织和硬组织成像中的诊断潜力。评分者间一致性一直很高（ICC：0.772 - 0.976；所有p < 0.001）。