Evaluation of common inspection techniques for acute atlantoaxial trauma

Abstract

Objective To evaluate and compare the 3 common inspection techniques for acute atlantoaxial trauma: tomosynthesis (DTS), digital radiology (DR) and computed tomography (CT). Methods The imaging data from March 2013 through December 2017 were retrieved from the Picture Archiving and Communication Systems (PACS) of The First Affiliated Hospital of Chongqing Medical University concerning the patients with acute atlantoaxial trauma.Selected for this study were 50 DTS images (DTS group), 50 CT images (CT group) and 50 DR images (DR group).The image diagnoses for the 3 groups were conducted by 2 senior radiologists and their judgments were compared with the definite clinical diagnoses.The 3 groups were compared in terms of diagnostic accuracy, diagnostic rate of acute atlantoaxial trauma, image quality and effective radiation dosage. Results DR was insignificantly different from DTS or CT in diagnostic accuracy for the acute atlantoaxial trauma which had been caused by mild violence like spraining and falling (P>0.05), but significantly inferior to both DTS and CT in diagnostic accuracy and diagnostic rate of the acute atlantoaxial trauma which had been caused by severe violence like traffic accident (P<0.05).In detection of atlas/axial fracture and atlantoaxial dislocation, DTS was slightly weaker than CT but significantly better than DR (P< 0.05).The image quality scores for CT group (4.60±0.11) and DTS group (4.16±0.15) were significantly higher than that for DR group (2.80±0.18) (P<0.05).In average effective radiation dosage, CT group (2.33±0.020 mSv/time) was the highest, followed by DTS group (0.61±0.076 mSv/time) and DR group (0.025±0.003 mSv/time), showing significant differences between any two (P<0.05). Conclusions DR technique may be used for inspection of the atlantoaxial acute trauma caused by mild violence like spraining and falling, but has little value for inspection of most cases of atlantoaxial acute trauma.DTS technique may be the first choice for inspection of most atlantoaxial acute trauma.CT should be applied as a further inspection for complex cases because of its highest diagnostic accuracy and highest effective radiation dosage. Key words: Atlas; Axis; Tomography, spiral computed; Tomosynthesis; Digital radiology