Diagnostic Accuracy of Maxillofacial Trauma Two-Dimensional and Three-Dimensional Computed Tomographic Scans: Comparison of Oral Surgeons, Head and Neck Surgeons, Plastic Surgeons, and Neuroradiologists

作者：Jarrahy Reza; Vo Victoria; Goenjian Haig A; Tabit Christina J; Katchikian Hurig V; Kumar Anand; Meals Clifton; Bradley James P^*

来源：Plastic and Reconstructive Surgery, 2011, 127(6): 2432-2440.

DOI：10.1097/PRS.0b013e318213a1fe

Background: The authors' objectives were to study differences in diagnostic accuracy between two- and three-dimensional computed tomographic scans and among the specialties of plastic surgery, head and neck surgery, oral surgery, and neuroradiology, since this had not previously been done.
Methods: Four groups of subspecialists completed time-proctored tests of 20 maxillofacial trauma scans with zygomatic arch, zygomatic complex, orbital, Le Fort I, II, III, mandibular and panfacial fractures from five institutions (n = 40). Accuracy of diagnosis and indication for surgery, efficiency, and preference were assessed. Comparison between two- and three-dimensional scans, between expert (experienced attending) versus novice (resident/fellow), and among the four subspecialties was performed.
Results: For two- and three-dimensional scans, two-dimensional was more accurate for orbital floor/medial wall (40 percent and 34 percent) and frontal sinus (26 percent for diagnostic) fractures. Two-dimensional examinations took 2.3 times longer but were preferred (85 percent). Experts and novices had similar accuracy with three-dimensional scanning, but experts were more accurate with the two- dimensional scanning. Experts were 3.3 times faster with two- dimensional scanning but not with three-dimensional scanning. Accuracy of diagnosis among subspecialists was similar, except that oral surgery was less accurate with orbitozygomatic fractures (79 percent versus 90 to 92 percent); neuroradiology was less accurate with indications for surgery (65 percent versus 87 to 93 percent).
Conclusions: Differences in diagnostic accuracy exist between two- and three-dimensional maxillofacial scans and between expert and novice readers but not between subspecialties. Combined modalities are preferred. (Plast. Reconstr. Surg. 127: 2432, 2011.)

• 出版日期2011-6