Imaging of traumatic mandibular fractures in young adults using CT-like MRI: a feasibility study

Abstract

Objectives To assess and compare the diagnostic performance of CT-like images based on a three- dimensional (3D) T1-weighted spoiled gradient-echo sequence (3D T1 GRE) with CT in patients with acute traumatic fractures of the mandible. Materials and methods Subjects with acute mandibular fractures diagnosed on conventional CT were prospectively recruited and received an additional 3 T MRI with a CT-like 3D T1 GRE sequence. The images were assessed by two radiologists with regard to fracture localization, degree of dislocation, and number of fragments. Bone to soft tissue contrast, diagnostic confidence, artifacts, and overall image quality were rated using a five-point Likert-scale. Agreement of measurements was assessed using an independent t-test. Results Fourteen subjects and 22 fracture sites were included (26 ± 3.9 years; 4 females, 10 males). All traumatic fractures were accurately detected on CT-like MRI (n = 22, κ 1.00 (95% CI 1.00–1.00)). There was no statistically significant difference in the assessment of the fracture dislocation (axial mean difference (MD) 0.06 mm, p = 0.93, coronal MD, 0.08 mm, p = 0.89 and sagittal MD, 0.04 mm, p = 0.96). The agreement for the fracture classification as well as the inter- and intra-rater agreement was excellent (range κ 0.92–0.98 (95% CI 0.96–0.99)). Conclusion Assessment of mandibular fractures was feasible and accurate using CT-like MRI based on a 3D T1 GRE sequence and is comparable to conventional CT. Clinical relevance For the assessment of acute mandibular fractures, CT-like MRI might become a useful alternative to CT in order to reduce radiation exposure particularly in young patients.

Editorial for “Comparing CT‐Like Images Based on Ultra‐Short Echo Time and Gradient Echo T1‐Weighted MRI Sequences for the Assessment of Vertebral Disorders Using Histology and True CT as the Reference Standard”

“…They can also gather information about the mineralization of the tumor matrix and soft tissue expansion. The role of CT‐like images has been demonstrated previously in the assessment of shoulder joint, 6 hands, 7 mandible, 8 vertebrae, 9 skull 4 and other issues like bony degenerative changes, 2 and bone neoplasm and metastasis 3 . However, these techniques are still new, and ex vivo evidence may contribute to a better understanding of the diagnostic value of CT‐like images in the assessment of vertebrae.…”