Clinical History
A 25-year-old male patient admitted to the emergency department after a motorcycle accident, with a facial trauma.
Imaging Findings
The 25-year-old male patient was involved in a motorcycle accident and sustained a facial trauma. The patient presented with pain and diplopia; on physical examination there was a marked swelling
found around the left orbit. A multirow CT study, on the axial plane, was perfomed and this demonstrated a comminuted fracture of the orbital floor (orbital blowout fracture). Multiplanar
reconstructions were performed on the sagittal and coronal planes, and an inferior rectus muscle engagement was demonstrated. Volume rendered reconstructions were generated to display the orbit
floor.
Discussion
The evaluation of craniofacial fractures plays a major role in the application of multiplanar reconstructions of CT data. The advantage of these reconstructions for the surgical treatment of
craniofacial fractures was demonstrated in the accurate evaluation of complex spatial relationships, which represented a dramatic improvement over the use of axial CT scans alone. For example, in an
orbital blowout fracture, we can better see the depression of the orbital floor, the herniation of the orbital fat and the entrapment of the inferior rectus muscle. By the use of modern CT scanners
it is possible to generate clinically accurate and immediately available 3D-images from the full CT scan data set without extensive editing. It allows the radiologist and surgeon to address specific
questions concerning patient care by interactively exploring different aspects of the data set. The volume rendering technique is particularly useful in detecting subcortical bone lesions and
minimally displaced fractures and in visualizing hidden areas of interest while creating few artefacts. 3D volume rendering is also indicated for post-operative follow-up in craniofacial fractures,
especially to evaluate osteosynthesis plaques position and eventual infectious complications.
Differential Diagnosis List
Blowout fracture of the left orbital floor.
Final Diagnosis
Blowout fracture of the left orbital floor.