TY - JOUR
T1 - Fractures of the tibial plateau
T2 - Value of spiral CT coronal plane reconstructions for detecting displacement in vitro
AU - McEnery, K. W.
AU - Wilson, A. J.
AU - Pilgram, T. K.
AU - Murphy, W. A.
AU - Marushack, M. M.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1994
Y1 - 1994
N2 - OBJECTIVE. The purpose of this in vitro study was to determine the value of spiral CT for detecting displacement of fractures of the tibial plateau. The exact amount of inferior plateau depression, if any, is a primary criterion for deciding between surgical management and conservative management. MATERIALS AND METHODS. An artificial fracture was produced in a cadaveric tibial plateau. Inferior displacements of 0, 1, 3, and 5 mm were created at the fracture. Spiral CT scans of each displacement were obtained with table speeds of 2, 3, and 5 mm/sec. Section collimation equaled table increment. Coronal image reconstructions were produced by use of standard scanner software. The images were interpreted by six musculoskeletal radiologists. RESULTS. Interpretation accuracy was greatest with coronal images created from the 2 mm/sec scans. For distinguishing 5-mm fracture displacements, the average diagnostic sensitivity and specificity were 96% and 93%, respectively; when a 2-mm depression was used as the criterion for clinical significance, the sensitivity was 100% and the specificity was 69%. CONCLUSION. When minimal table increment and collimation are used, spiral CT can detect clinically important inferior depressions of tibial plateau fractures. On the basis of the results of this study, when spiral CT is used for tibial plateau fracture assessment, we recommend 2-mm section collimation, 2-mm table speed, and reconstruction of images at 1-mm increments.
AB - OBJECTIVE. The purpose of this in vitro study was to determine the value of spiral CT for detecting displacement of fractures of the tibial plateau. The exact amount of inferior plateau depression, if any, is a primary criterion for deciding between surgical management and conservative management. MATERIALS AND METHODS. An artificial fracture was produced in a cadaveric tibial plateau. Inferior displacements of 0, 1, 3, and 5 mm were created at the fracture. Spiral CT scans of each displacement were obtained with table speeds of 2, 3, and 5 mm/sec. Section collimation equaled table increment. Coronal image reconstructions were produced by use of standard scanner software. The images were interpreted by six musculoskeletal radiologists. RESULTS. Interpretation accuracy was greatest with coronal images created from the 2 mm/sec scans. For distinguishing 5-mm fracture displacements, the average diagnostic sensitivity and specificity were 96% and 93%, respectively; when a 2-mm depression was used as the criterion for clinical significance, the sensitivity was 100% and the specificity was 69%. CONCLUSION. When minimal table increment and collimation are used, spiral CT can detect clinically important inferior depressions of tibial plateau fractures. On the basis of the results of this study, when spiral CT is used for tibial plateau fracture assessment, we recommend 2-mm section collimation, 2-mm table speed, and reconstruction of images at 1-mm increments.
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U2 - 10.2214/ajr.163.5.7976896
DO - 10.2214/ajr.163.5.7976896
M3 - Article
C2 - 7976896
AN - SCOPUS:0028052037
SN - 0361-803X
VL - 163
SP - 1177
EP - 1181
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 5
ER -