A comparison of the diagnostic ability between waters' radiograph and computed tomography in the diagnosis of midf acial fracture

Jeon, In Seong; Choi, Soon Chul

Abstract

This study was intended to compare the diagnostic ability between Waters' radiograph and CT in the diagnosis of mi dfacial fracture. The study group included 44 patients(male:32, female:12, age range:16-74 yeards old) with facial injur y who underwent surgery. Waters' radiograph and both axial and coronal scanning were performed before surgery, Three oral raiologists and thre e non-oral radiologist interpreted 44 waters' radiographs and 88 CT in three ways: 1) interpretation using waters' radi ograph only, 2) interpretation using CT only, 3) interpretation using Waters' radiograph and CT. The interpretation sites were confined to the walls of maxillary sinus; anterior, posterior, medial, lateral and superior wall. ROC curves were made with the findings during surery as a gold standard except the posterior wall, where the joint evaluation of Waters' radiograph and CT by othe three oral raiologists was used. ROC areas were compared according to the interpreting methods, the interpretation sites, and groups (R group ; oral r adiologist group, N group ; non-oral radiologist group). The obtained results were as followed : 1. The diagnostic ability of CT only and Waters' radiograph and CT was higher than Waters' radiograph only in b oth groups(P<0.05). but there was no difference between ct only and waters > 2. Generally, the diagnostic ability for the lateral antral wall was the highest and that for the posterior antral wall was the lowest in both groups(P<0.05) 3. In R gruop, for the anterior antral wall the diagnostic ability using CT only was increased but for the medial, late ral and superior antral walls the diagnostic ability was increased in only using Waters' radiograph and CT. 4. In N group, for the anterior and medial walls the diagnostic ability using CT only was increased, But for the poster ior, lateral and superior antral walls there were no difference among three interpreting methods. 5. The diagnostic ability of R group was higher than N group in all interpreting methods.