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MATERIALS AND METHODS: CT images of 36 patients with maxillofacial fractures (symptomatic to orbit region) who were submitted to multislice CT scanning were analyzed, retrospectively. OBJECTIVE: The objective of this study was to demonstrate the sensitivity and specificity of multislice computed tomography (CT) for diagnosis of orbital fractures following different protocols, using an independent workstation. Adjunct Assistant Professor, Department of Radiology, College of Medicine, University of Iowa, Iowa City, USA IVPhD, Professor, Department of Radiology, College of Dentistry, University of São Paulo. IIIMD, Professor, Department of Radiology, College of Medicine, University of Iowa, Iowa City, USA IIPhD, Professor, Department of Radiology, College of Dentistry, University of São Paulo IPhD, Oral and Maxillofacial Radiology, Department of Radiology, College of Dentistry, University of São Paulo, São Paulo, Brazil Orbital fractures X-ray computed tomography Computer-assisted diagnosisĬomputed tomography imaging strategies and perspectives in orbital fracturesĭenise Takehana dos Santos I Jefferson Xavier Oliveira II Michael Walter Vannier III Marcelo Gusmão Paraíso Cavalcanti IV

This protocol can add valuable information to the diagnosis of fractures using the association of axial/MPR/3D with multislice CT. CONCLUSIONS: Except for the axial images, which presented a low sensitivity, all methods evaluated in this study showed high specificity and sensitivity for the diagnosis of orbital fractures according to the proposed methodology. On the other hand, the diagnostic value of axial images was considered limited for orbital fractures region, with sensitivity of 44.2%. RESULTS: 3D-CT scanning presented sensitivity of 78.9%, which was not superior to that of MPR (84.0%), axial/MPR/3D (90.5%) and coronal images (86.1%). The clinical and/or surgical findings (medical records) were considered as the gold standard to corroborate the diagnosis of the anatomical localization of the orbital fracture. The collected data were analyzed statistically using a validity test (Youden's J index p<0.05). The evaluated anatomical sites were divided according to the orbital walls: lateral (with or without zygomatic frontal process fracture) medial superior (roof) and inferior (anterior, medial). The images were interpreted based on 5 protocols, using an independent workstation: 1) axial (original images) 2) multiplanar reconstruction (MPR) 3) 3D images 4) association of axial/MPR/3D images and 5) coronal images.