Modern approaches to midface trauma diagnostics according to MSCT data

Modern approaches to midface trauma diagnostics according to MSCT data

Pavlova O.Yu., Serova N.S., Davydov D.V.

Purpose. Improving radiology diagnostics in patients with traumatic madface injuries, developing methods for postprocessing of multispiral computed tomography (MSCT) data in patients with orbital injury in order to obtain additional diagnostic information and choose treatment tactics for patients.

Materials and methods. From 2014 to 2018 in Sechenov University 107 patients (100%) with traumatic midface injuries were examined. During hospitalization all patients (n=107; 100%) underwent diagnostic examination  within 24-48 hours from admission.

Multislice computed tomography was performed using Aquilion One 640 (Canon, Japan) scanner, in a volume mode, with a slice thickness of 0.5 mm, with bone and soft tissue reconstructions. The study was complemented by multiplanar and three-dimensional reconstructions. For the subsequent processing of CT data, the “Vitrea” workstation was used.

Results. In 51 patients (48%), the volume of the injured orbit was not increased. In 35 patients (33%), an increase in orbit volume was detected by visual assessment and using the developed calculation method according to MSCT data. In 21 cases (19%), no visual changes in the orbit were observed during the visual assessment of MSCT, however, using an additional data processing technique, an increase in volumes of a more critical value was revealed – 2 ml.

The type of defect was determined on the basis of the developed classification, taking into account the values of the volumes and areas of inferior orbital wall defects. Small defect of the lower wall of the orbit was determined in 18 patients (17%), medium – in 31 patients (29%), large – in 38 patients (35%), total – in 20 patients (19%).

Out of 107 patients in 26 cases (24%), the globe displacement was visually determined according to MSCT, which was confirmed by the calculation method. Another 9 patients (8.1%) using the developed calculation method showed signs of enophthalmos, which was not visualized with standard processing of MSCT data. In one case (0.9%) visually, according to MSCT, there was a suspicion of the presence of enophthalmos, which was not confirmed by the developed technique. In other cases (n=71; 66%), signs of enophthalmos were not determined either visually according to MSCT, or using the calculation method.

In the majority of cases (n = 60; 56%), CT-signs of orbital edema of soft tissues were determined in patients, signs of atrophy of soft orbital tissues were detected in 28 patients (27%), in 10 patients (9%) of patients - hematoma in the soft orbital tissues, in 9 patients (8%) patients – the density of the soft orbital tissues was not changed.

Conclusion. MSCT is the method of choice for examining patients with injuries of the middle zone of the face. The developed methods for measuring orbit volumes, assessing defects in the lower wall of the orbit, the position of the eyeballs, and the condition of the soft tissues of the orbits provide additional diagnostic information about the patient’s condition and a personalized approach to preoperative planning for each patient with orbital injury.

1 –Sechenov University.

2 - Peoples' Friendship University of Russia. Moscow, Russia.



Keywords: orbital trauma, multispiral computed tomography, orbital volume, inferior orbital wall defect.


Corresponding author:  Pavlova O.Yu., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript .


For citation: Pavlova O.Yu., Serova N.S., Davydov D.V. Modern approaches to midface trauma diagnostics according to MSCT data. REJR 2019; 9(4):18-30. DOI:10.21569/2222-7415-2019-9-4-18-30.


Received:        21.09.19 Accepted:       25.10.19