The diagnostic value of the sagittal multiplanar reconstruction CT images for nasal bone fractures

Aim: To compare the diagnostic performance of sagittal multiplanar reconstruction (MPR) images and axial images for the detection of a nasal bone fracture. Materials and methods: This prospective study included 533 consecutive patients who underwent three-dimensional images with 64-section multidetector-row CT for the evaluation of a facial bone fracture between June 2007 and May 2008 (366 males; 167 females; mean age ± standard deviation 31.1 ± 21.2 years; age range 1-92 years). Two observers independently scored the possibility of a nasal bone fracture on axial and sagittal images. Receiver operating characteristic (ROC) curve analysis was performed. Results: The Az values of the sagittal images were higher than those of the axial images for both observers (p = 0.002 and 0.010, respectively) with higher accuracy (p < 0.001 and 0.016, respectively). The sensitivities of sagittal images were superior to those of axial images, especially for type 1 simple nasal bone fractures with no or minimal displacement (observer 1, 98.6 versus 72.8%; observer 2, 84.9 versus 71%). Conclusion: Sagittal MPR facial bone CT images provided superior diagnostic performance, and their addition to axial images is useful for the evaluation of nasal bone fractures.