Neuroimaging clinics of North America
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Basilar skull fractures are a relatively frequent occurrence in significant head trauma, and their detection is important, as even linear nondisplaced fractures can be associated with critical complications. The management of skull base fractures depends on the location and extent of these associated complications. This article reviews skull base anatomy; morphology of the common fracture patterns within the anterior, central, and posterior skull base; associated complications; imaging findings; and possible pitfalls in imaging of skull base trauma.
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In the clinical assessment of orbital trauma, visual acuity and extraocular muscle motility are critical for rapid evaluation of injury severity. However, assessment of these parameters may be limited by edema and concomitant injuries. ⋯ This review focuses on orbital soft-tissue injuries that can exist with or without orbital fracture. Imaging techniques and soft-tissue injuries, including those involving the anterior chamber, iris and ciliary body, lens, globe, posterior segment, and optic nerve, are reviewed, in addition to intraocular foreign bodies and cavernous-carotid fistulas.
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Over the last two decades, there has been a marked increase in the number of computed tomography (CT) studies performed in the United States, with a resultant increase in the radiation dose delivered to patients. Hence there is an urgent need to optimize CT protocols and to get familiar with the factors affecting the CT radiation dose and with available dose reduction options. This article discusses the basic physics related to CT technique and describes current and future methods of dose reduction. Also briefly described are other CT techniques applicable in the maxillofacial region, such as three-dimensional CT, cone beam CT, and dual-energy CT.
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Knowledge of relevant anatomy and underlying mechanisms of traumatic injury is essential for understanding the radiologic findings in craniofacial trauma and their clinical importance. Craniofacial anatomy is diverse, and as a result of this anatomic diversity, physicians from numerous different specialties scrutinize similar imaging sets, looking for different pathologic abnormalities within the same anatomic regions. Radiologists familiar with the chief concerns of this anatomically diverse region can help expedite the decision-making process by keeping those concerns in mind when they report their findings. This review provides an overview of situations wherein surgical management may be indicated.
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Temporal bone trauma is commonly seen in patients with craniofacial injury and can be detected using multidetector computed tomography. A thorough understanding of the different types of temporal bone fracture patterns is needed to accurately describe the trajectory of injury as well as anticipated complications. Fractures should be described based on direction, segment of temporal bone involved, as well as involvement of the otic capsule. More importantly, the radiologist plays an integral role in identifying complications of temporal bone injury, which often have significant clinical implications.