3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures

Introduction: Rib fractures are common presentations at emergency departments across the UK. 21% of emergency admissions are related to rib fractures, resulting from up to 39% of all blunt-trauma to the chest. Imaging is essential for identification of rib fractures but also for planning potential surgical intervention. The introduction of 3D imaging has enhanced the pre-surgical planning in many fields of medicine. We compared 3D CT in the identification of rib fractures to conventional 2D radiology. Methods: A retrospective cohort study of 22 patients was conducted at a district general hospital between Novembers 2014-2016. Chest X-ray, 2D CT and 3D CT findings were compared for the number of rib fractures and identification of displacement of rib fractures. Statistical analysis was performed using a 3-way ANOVA, with Cohen’s kappa statistic (κ) to identify agreement. There were 22 patients (20M: 2F) patients in this study. The mean age of patients was 50.2 ±21.7 (range 10-94). Chest X-rays had the poorest identification rate with slight agreement with 3D CT (κ=0.018). There was also a slight agreement for identification of displacement between 2D and 3D CT imaging (κ=0.127) Conclusion: Chest X-ray on its own is inferior to 2D and 3D CT. 3D CT adds to the value of 2D imaging as it gives an enhanced view of any possible fracture displacement.