J Korean Soc Radiol.  2012 Jan;66(1):77-82. 10.3348/jksr.2012.66.1.77.

Diagnostic Accuracy of the Volume Rendering Images of Multi-Detector CT for the Detection of Lumbar Transverse Process Fractures

• Lee Y
• Chun TJ

• KMID: 2208875
• DOI: http://doi.org/10.3348/jksr.2012.66.1.77

Abstract

PURPOSE
To compare the accuracy of three-dimensional computed tomographic (3D CT) volume rendering techniques with axial images of multi-detector row computed tomography to identify lumbar transverse process (LTP) fractures in trauma patients.
MATERIALS AND METHODS
We retrospectively evaluated 42 patients with back pain as a result of blunt trauma between January and June of 2010. Two radiologists examined the 3D CT volume rendering images independently. The confirmation of a LTP fracture was based on the consensus of the axial images by the two radiologists. The results of 3D CT volume rendering images were compared with the axial images and the diagnostic powers (sensitivity, specificity, and accuracy) were calculated.
RESULTS
Seven of the 42 patients had twenty five lumbar transverse process fractures. The diagnostic power of the 3D CT volume rendering technique is as accurate as axial images. Reader 1, sensitivity 96%, specificity 100%, accuracy 99.9%; and Reader 2 sensitivity 100%, specificity 99.8%, accuracy 99.8%. The accordance of the two radiologists was 99.8%.
CONCLUSION
3D CT volume rendering images can alternate axial images to detect lumbar transverse process fractures with good image quality.

MeSH Terms

Back Pain
Consensus
Humans
Lumbar Vertebrae
Retrospective Studies
Sensitivity and Specificity
Spinal Fractures

Reference

1. Patten RM, Gunberg SR, Brandenburger DK. Frequency and importance of transverse process fractures in the lumbar vertebrae at helical abdominal CT in patients with trauma. Radiology. 2000. 215:831–834.

2. Sturm JT, Perry JF Jr. Injuries associated with fractures of the transverse processes of the thoracic and lumbar vertebrae. J Trauma. 1984. 24:597–599.

3. Miller CD, Blyth P, Civil ID. Lumbar transverse process fractures--a sentinel marker of abdominal organ injuries. Injury. 2000. 31:773–776.

4. Mann FA, Cohen WA, Linnau KF, Hallam DK, Blackmore CC. Evidence-based approach to using CT in spinal trauma. Eur J Radiol. 2003. 48:39–48.

5. Krueger MA, Green DA, Hoyt D, Garfin SR. Overlooked spine injuries associated with lumbar transverse process fractures. Clin Orthop Relat Res. 1996. 191–195.

6. Novelline RA, Rhea JT, Rao PM, Stuk JL. Helical CT in emergency radiology. Radiology. 1999. 213:321–339.

7. Brant-Zawadzki M, Jeffrey RB Jr, Minagi H, Pitts LH. High resolution CT of thoracolumbar fractures. AJR Am J Roentgenol. 1982. 138:699–704.

8. Hauser CJ, Visvikis G, Hinrichs C, Eber CD, Cho K, Lavery RF, et al. Prospective validation of computed tomographic screening of the thoracolumbar spine in trauma. J Trauma. 2003. 55:228–234. discussion 234-235.

9. Scott WW Jr, Fishman EK, Magid D. Acetabular fractures: optimal imaging. Radiology. 1987. 165:537–539.

10. Alkadhi H, Wildermuth S, Marincek B, Boehm T. Accuracy and time efficiency for the detection of thoracic cage fractures: volume rendering compared with transverse computed tomography images. J Comput Assist Tomogr. 2004. 28:378–385.

11. Flohr TG, Schaller S, Stierstorfer K, Bruder H, Ohnesorge BM, Schoepf UJ. Multi-detector row CT systems and image-reconstruction techniques. Radiology. 2005. 235:756–773.

12. Philipp MO, Kubin K, Mang T, Hörmann M, Metz VM. Three-dimensional volume rendering of multidetector-row CT data: applicable for emergency radiology. Eur J Radiol. 2003. 48:33–38.