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Four-Channel Multidetector CT in Facial Fractures: Do We Need 2 x 0.5 mm Collimation?

¹ Department of Radiology, Division of Surgery, University of Vienna Medical School, General Hospital Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
² Department of Radiology, Harborview Medical Center, 325 9th Ave., Box 359728, Seattle, WA 98104.
³ Department of Radiology, Division of Osteology, University of Vienna Medical School, General Hospital Vienna, 1090 Vienna, Austria.

View larger version (155K): [in a new window]   Fig. 1A. —70-year-old female cadaver with fracture of medial wall and floor of left maxillary sinus (arrows) and fracture of frontal sinus (arrowhead). Coronal multiplanar reformations (slice thickness, 1 mm; overlap, 0.5 mm) obtained from 4 x 1 mm collimation with 120 mAs show clear evidence of fractures in ultra-high-resolution mode (A) and no fracture reliably visible in non–ultra-high-resolution mode (B).

View larger version (149K): [in a new window]   Fig. 1B. —70-year-old female cadaver with fracture of medial wall and floor of left maxillary sinus (arrows) and fracture of frontal sinus (arrowhead). Coronal multiplanar reformations (slice thickness, 1 mm; overlap, 0.5 mm) obtained from 4 x 1 mm collimation with 120 mAs show clear evidence of fractures in ultra-high-resolution mode (A) and no fracture reliably visible in non–ultra-high-resolution mode (B).

View larger version (146K): [in a new window]   Fig. 2A. —70-year-old female cadaver with fracture of medial wall and floor of left maxillary sinus (arrows) and fracture of frontal sinus (arrowhead). Coronal multiplanar reformations (slice thickness, 1 mm; overlap, 0.5 mm) obtained from 4 x 1 mm collimation in ultra-high-resolution mode show clear evidence of fractures with 120 mAs (A), fractures not reliably visible with 90 mAs (B), and all fractures insufficiently detectable with 60 mAs.

View larger version (147K): [in a new window]   Fig. 2B. —70-year-old female cadaver with fracture of medial wall and floor of left maxillary sinus (arrows) and fracture of frontal sinus (arrowhead). Coronal multiplanar reformations (slice thickness, 1 mm; overlap, 0.5 mm) obtained from 4 x 1 mm collimation in ultra-high-resolution mode show clear evidence of fractures with 120 mAs (A), fractures not reliably visible with 90 mAs (B), and all fractures insufficiently detectable with 60 mAs.

View larger version (157K): [in a new window]   Fig. 2C. —70-year-old female cadaver with fracture of medial wall and floor of left maxillary sinus (arrows) and fracture of frontal sinus (arrowhead). Coronal multiplanar reformations (slice thickness, 1 mm; overlap, 0.5 mm) obtained from 4 x 1 mm collimation in ultra-high-resolution mode show clear evidence of fractures with 120 mAs (A), fractures not reliably visible with 90 mAs (B), and all fractures insufficiently detectable with 60 mAs.

View larger version (102K): [in a new window]   Fig. 3A. —70-year-old female cadaver with fracture of roof of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 3 mm; overlap, 0.5 mm) obtained from 2 x 0.5 mm collimation with 120 mAs in ultra-high-resolution mode clearly shows fracture.

View larger version (99K): [in a new window]   Fig. 3B. —70-year-old female cadaver with fracture of roof of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 3 mm; overlap, 0.5 mm) obtained from 4 x 1 mm collimation with 120 mAs in ultra-high-resolution mode. Fracture is not detectable.

View larger version (114K): [in a new window]   Fig. 3C. —70-year-old female cadaver with fracture of roof of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 3 mm; overlap, 0.5 mm) obtained from 4 x 2.5 mm collimation with 120 mAs in non–ultra-high-resolution mode. Fracture is not detectable.

View larger version (134K): [in a new window]   Fig. 4A. —70-year-old female cadaver with fracture of floor of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 0.5 mm; overlap, 0.5 mm) obtained from 2 x 0.5 mm collimation with 120 mAs in ultra-high-resolution mode clearly shows fracture.

View larger version (118K): [in a new window]   Fig. 4B. —70-year-old female cadaver with fracture of floor of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 1 mm; overlap, 0.5 mm) obtained from 2 x 0.5 mm collimation with 120 mAs in ultra-high-resolution mode shows fracture with less quality.

View larger version (108K): [in a new window]   Fig. 4C. —70-year-old female cadaver with fracture of floor of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 3 mm; overlap, 0.5 mm) obtained from 2 x 0.5 mm collimation with 120 mAs in ultra-high-resolution mode shows that fracture is questionable.

View larger version (107K): [in a new window]   Fig. 4D. —70-year-old female cadaver with fracture of floor of maxillary sinus (arrow). Sagittal multiplanar reformation (slice thickness, 3 mm; overlap, 3 mm) obtained from 2 x 0.5 mm collimation with 120 mAs in ultra-high-resolution mode shows that fracture is extremely doubtful.

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