Three Dimensional Digital Rotational Imaging in the Evaluation of the Fractures

PURPOSE: To evaluate the usefulness and the application of three dimensional digital rotational imaging (3D DRI) by the evaluation of fractures. MATERIALS AND METHODS: Sixteen patients with clinically diagnosed or suspicious fracture were involved in this study. The lesion or suspicious sites of all 16 cases were spines (n=7), pelvis (n=3) and so on (n=6; knee, elbow, ankle, wrist and foot). In all cases, conventional radiography, multiplanar 2D (slice thickness/pitch=3 or 5 mm/1:1)and volume rendering 3D reconstructed single detector helical CT (HiSpeed Advantage, GE Medical Systems, Milwaukee, WIS) scans and 3D DRI (Integris V-5000,Philips Medical Systems, The Netherlands) with multiplanar intersection and gray scaling as postprocessing technique were performed. 3D DRI was evaluated and compared with conventional radiography, multiplanar 2D CT and volume rendering 3D CT. RESULTS: 3D DRI provided more detail and additional information in 14 cases (88%), comparing with 2D and 3D CT scans. Two fractures were revealed only on 3D DRI other than conventional radiography and CT scans and one case was revealed on 2D CT and 3D DRI. In all cases, we could acquired more detail and additional information from 3D DRI than from 3D CT in the acquisition of 3D imaging. 3D DRI didn't change the classification of fracture in 12 of 13 cases (92%),which revealed the fracture on the conventional radiography or CT. CONCLUSION: 3D DRI can diagnose and evaluate the fracture rapidly and easily with anatomical and spatial resolution by acquisition of 3D imaging with postprocessing using DRI.

Tympanosclerosis of the Middle Ear: Radiologic-Surgical Correlation

PURPOSE: Tympanosclerosis is a common problem causing conductive hearing loss accompanied by chronic otitismedia. The purpose of this study was to evaluate the CT findings of tympanosclerosis, and correlate them with thesurgical findings. MATERIALS AND METHODS: The CT scans of 17 patients with surgically-proven tympanosclerosis andthose of a control group of 34 patients with nontympanosclerotic chronic otitis media were reviewed. According totheir location, they were assigned to one of three groups; tympanic membrane, epitympanum, or ossicles. RESULTS: Tympanosclerosis was found during surgery to be located in the tympanic membrane (n=11), the epitympanum (n=6), oraround the ossicles(n=8). Calcification of the tympanic membrane, ossicular thickening, narrowing of theepitympanum and calcification of the tympanic cavity occurred to a significant extent, and were more often afeature of tympanosclerosis than of nontympanosclerotic chronic otitis media (p <0.05). As an indicater of tympanicmembrane involvement, sensitivity and specificity of calcification of the tympanic membrane were 73% and 83%,respectively. As an indicator of ossicular involvement, the corresponding figures for ossicular thickening were50% and 93% ; as an indicator of involvement of the tympanic cavity (especially the epitympanum) the figures fornarrowing of the epitympanum and calcification of the tympanic cavity were 50% and 50% (respective sensitivities),and 89% and 93%(respective specificities). CONCLUSION: Tympanosclerosis usually appears on CT as ossicularthickening, narrowing of the epitympanum, calcification of the tympanic membrane and/or tympanic cavity. CT isvery helpful in evaluating ossicular involvement and determining the appropriate surgical treatment oftympanosclerosis.