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Purpose <p>To compare the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for surgically relevant parameters in mandibular trauma, evaluating five in-house-optimized MRI protocols with a dedicated 15-channel mandibular coil.</p> Methods <p>Fifteen patients with 30 acute mandibular fractures underwent 3T MRI using five optimized protocols: UTE, StarVIBE, Dark Bone, DESS, and STIR. Three independent observers qualitatively rated image quality, fracture line visibility, cortical delineation, and bone-to-soft-tissue contrast on a five-point visual analog scale (5 = best, 1 = lowest). Quantitative analysis included measurement of the maximum distance of the fracture gap. Descriptive statistics and inter-observer agreement (Krippendorff’s α) were calculated.</p> Results <p>CT enabled rapid and accurate fracture detection in all cases. Among MRI protocols,&#xa0;UTE (85% of fractures correctly identified and accurately diagnosed) and StarVIBE (75%) demonstrated the best diagnostic performance, with excellent fracture line visibility, sharp cortical delineation, and strong inter-observer agreement (α = 0.7–1.0.7.0). Dark Bone and DESS provided variable results, while STIR was the least suitable for fracture depiction despite good soft-tissue contrast. Quantitative assessment of fracture gap distance showed the highest accuracy with StarVIBE, demonstrating minimal deviation compared to CT (0.13–0.21&#xa0;mm; <i>p</i> &gt; 0.05).</p> Conclusion <p>While CT remains the standard in emergency settings and for delineating complex osseous pathologies, MRI, combining CT-like and water-sensitive sequences, offers a promising radiation-free alternative for simultaneous visualization of hard and soft tissues. This approach may facilitate comprehensive radiation-free trauma evaluation, improve detection of concomitant injuries, and further support individualized clinical decision-making.</p> Trial registration number <p>&#xa0;Swiss National Clinical Trials Portal: SNCTP000006343, ClinicalTrials.gov ID: NCT07012850.</p>

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Diagnostic performance of CT and MRI in mandibular trauma assessment – a prospective comparative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月27日

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  • Adib Al-Haj Husain,
  • Sameena Sandhu,
  • Maximilian Eberhard Hermann Wagner,
  • Egon Burian,
  • Suen An Nynke Lie,
  • Marc M. Precht,
  • Daniel Zedler,
  • Thomas Frauenfelder,
  • Andreas M. Hötker,
  • Bernd Stadlinger,
  • Stefan Sommer,
  • Peter Kessler,
  • Harald Essig

摘要

Purpose

To compare the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for surgically relevant parameters in mandibular trauma, evaluating five in-house-optimized MRI protocols with a dedicated 15-channel mandibular coil.

Methods

Fifteen patients with 30 acute mandibular fractures underwent 3T MRI using five optimized protocols: UTE, StarVIBE, Dark Bone, DESS, and STIR. Three independent observers qualitatively rated image quality, fracture line visibility, cortical delineation, and bone-to-soft-tissue contrast on a five-point visual analog scale (5 = best, 1 = lowest). Quantitative analysis included measurement of the maximum distance of the fracture gap. Descriptive statistics and inter-observer agreement (Krippendorff’s α) were calculated.

Results

CT enabled rapid and accurate fracture detection in all cases. Among MRI protocols, UTE (85% of fractures correctly identified and accurately diagnosed) and StarVIBE (75%) demonstrated the best diagnostic performance, with excellent fracture line visibility, sharp cortical delineation, and strong inter-observer agreement (α = 0.7–1.0.7.0). Dark Bone and DESS provided variable results, while STIR was the least suitable for fracture depiction despite good soft-tissue contrast. Quantitative assessment of fracture gap distance showed the highest accuracy with StarVIBE, demonstrating minimal deviation compared to CT (0.13–0.21 mm; p > 0.05).

Conclusion

While CT remains the standard in emergency settings and for delineating complex osseous pathologies, MRI, combining CT-like and water-sensitive sequences, offers a promising radiation-free alternative for simultaneous visualization of hard and soft tissues. This approach may facilitate comprehensive radiation-free trauma evaluation, improve detection of concomitant injuries, and further support individualized clinical decision-making.

Trial registration number

 Swiss National Clinical Trials Portal: SNCTP000006343, ClinicalTrials.gov ID: NCT07012850.