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Erschienen in:
01.11.2010 | Scientific Article
Finger fractures imaging: accuracy of cone-beam computed tomography and multislice computed tomography
Erschienen in: Skeletal Radiology | Ausgabe 11/2010
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Objective
To compare the diagnostic accuracy and radiation exposure of cone beam computed tomography (CBCT) and multislice computed tomography (MSCT) in the evaluation of finger fractures.
Materials and methods
In a 3-year period, 57 consecutive patients with post-traumatic fractures of the metacarpal–phalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints with involvement of the articular surface were studied by means of CBCT and MSCT. Student’s t test was used to compare CBCT and MSCT accuracy in evaluating the percentage of joint surface involvement and in detecting bone fragments. The average tissue-absorbed doses of CBCT and MSCT were also compared. A value of p < 0.05 was considered statistically significant. Inter-observer agreement was calculated.
Results
In all cases, CBCT allowed the percentage of articular involvement to be correctly depicted compared with MSCT, showing 100% sensitivity and specificity (p < 0.001). A total of 103 bone fragments were depicted on MSCT (mean 3.8 per patient, range 1–23). CBCT indicated 92 out of 103 fragments (89.3%) compared with MSCT (mean diameter of missed fragments 0.9 mm, range 0.6–1.3 mm), with no statistically significant difference between CBCT and MSCT (p < 0.025). Multislice CT radiation exposure was significantly higher than that of CBCT (0.18 mSv vs 0.06 mSv, p < 0.0025). Inter-observer agreement was good (overall κ = 0.89–0.96).
Conclusions
Cone beam CT may be considered a valuable imaging tool in the preoperative assessment of finger fractures, when MSCT is not available.