Detection of cervical spine trauma: Are 3-dimensional reconstructed images as accurate as multiplanar computer tomography?

Introduction: This study was conducted to assess the diagnostic accuracy of three-dimensional computed tomography (3D-CT) in detection of cervical spine injuries in symptomatic post-trauma patients using multiplanar computed tomography (MP-CT) as reference standard.

Approach: This cross-sectional study was conducted at Aga Khan University from July 2016 to January 2017. Patients were included using a non-probability, consecutive sampling. MP-CT and 3D- CT images were obtained and evaluated by a senior radiologist to identify cervical spine injuries.

Results: 205 patients were included in the study. For fractures, 3D-CT images had sensitivity of 71%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 96.8% and diagnostic accuracy of 97%. For dislocations, 3D-CT reported sensitivity of 83.34%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.5% and diagnostic accuracy of 99.5%.

Conclusion: 3D-CT has good diagnostic accuracy for injuries of the cervical spine but must be reviewed simultaneously with multiplanar CT images.