Comparison between radiography and computed tomography for diagnosis of equine skull fractures

Abstract

Summary The equine head is a complex structure prone to traumatic injuries. To determine the value and limitations of radiography and (CT) for the diagnosis of skull fracture, the differences between the two modalities were described. Two observers retrospectively reviewed the radiographic and CT images of 18 horses with a skull fracture. To allow direct comparison between the two modalities, a simplified fracture classification system was used. In 3/18 cases the evaluation of the radiographic examination concluded no injuries visible. In 2/15 cases soft tissue involvement was not detected and in 7/15 cases the extension of the fracture was underestimated with radiography. Radiography classified 4/10 multiple fractures incorrectly as single fracture and 5/15 comminuted fractures on CT were diagnosed as simple fracture with radiography. The number of fragments was underestimated with radiography in 14/15 cases. In conclusion, radiography is able to diagnose a skull fracture in most cases. Skull fractures however are not similarly classified after radiographic and CT evaluation, which causes a difference in interpretation and perception of the fractures. Therefore, CT should be the modality of choice for surgical planning and prognosis.

Application and indications of magnetic resonance imaging and computed tomography of the equine head

“…Ultrasonography is a useful imaging tool for evaluating the bone surface, therefore in some instances can be used for diagnosing skull fractures, specially to the most superficial bones. Although most skull fractures can be diagnosed radiographically, CT is superior in identifying the exact extent and configuration of osseous changes, and allows detailed assessment of the involved structures, such as the infraorbital canal, nasolacrimal duct, cranial nerve foramina, calvarium, temporomandibular joint, teeth or airways (Crijns et al 2019). Although MRI is very sensitive at identifying bone marrow lesions, flat bones and petrous temporal bones are shown as black areas due to signal void on MRI.…”

“…The presence of gas within the airways (paranasal sinuses, pharynx and guttural pouches) surrounding these flat bones complicate detailed assessment of osseous structures with MRI even further. Hence CT is considered the method of choice for the assessing osseous structures of the head (Manso-D ıaz et al 2015b;Crijns et al 2019).…”

Succesvolle behandeling van een open os incisivumfractuur van de bovenkaak met een compressieplaat met vergrendelde schroeven in combinatie met intraorale cerclage bij een paard

“…In these cases, surgical intervention is necessary (Dixon et al, 2008). Computed tomography is a valuable tool in the diagnosis of head fracture as well as for presurgical planning of fracture repair (Crijns et al, 2019;Nixon, 2020).…”

Multidetector CT and cone‐beam CT have substantial agreement in detecting dental and sinus abnormalities in equine cadaver heads

“…Disorders affecting the head are common in horses and diagnostic imaging is required in many cases 1 . Head radiographs can be difficult to interpret due to complexity of anatomic structures and superimposition 2–4 . Computed tomography now plays an important role in imaging of the equine head and has become best practice for imaging of this area 5–9 .…”