안면외상 환자의 외상성 뇌손상의 예측 인자로 안면 전산화단층촬영을 이용한 시각신경집 지름 측정의 유용성

Abstract

Purpose: Traumatic brain injury (TBI) occurs frequently in patients with facial injuries. In patients with facial injuries without neurologic deficit, it is a challenging decision for emergency physicians whether brain computed tomography (CT) is necessary or not. Our objective is to evaluate the availability of optic nerve sheath diameter (ONSD) measured by facial CT in predicting TBI. Methods: From January, 2010, to December, 2012, we conducted a retrospective study of patients with head or facial injuries who underwent both facial CT and brain CT simultaneously in the emergency department. Patients with obvious orbital trauma or ocular disease were excluded. We analyzed correlation between ONSD measured by facial CT and the brain CT findings of TBI. Results: A total of 229 patients were enrolled. Ninety six patients without TBI on facial CT showed mean ONSD of 5.11±0.44 mm, and 82 patients with TBI showed mean ONSD of 5.89±0.78 mm. The sensitivity and the specificity compared with the presence of TBI findings on brain CT were 78.05% and 82.29%, respectively, when the cut-off value was set to 5.5 mm. The area under the curve (AUC) was 0.826 in the receiver operating characteristic curve (ROC curve). Conclusion: ONSD measured on facial CT is available for predicting TBI in patients with facial injuries.