RadteraCT Facial Bones / Maxillofacial
CTNo contrastHead & Neck
Indications
- Facial trauma — assessment of midface, orbital, nasal, mandibular, Le Fort and zygomaticomaxillary complex (ZMC/tripod) fractures
- Pre-operative planning for facial fracture repair
- Suspected facial bone osteomyelitis, mass, or infection (with contrast)
- Postoperative hardware evaluation
Patient prep
- No prep for non-contrast trauma study; remove dentures/metallic objects when feasible
- For suspected infection/mass with contrast: screen eGFR, IV access, document allergy
- Supine head-first; maintain neutral position (do not manipulate in acute trauma with possible c-spine injury)
Contrast
None / non-contrast
Technique
- Supine, head first; thin-section helical volume from frontal sinus/orbital roof through mandible (include full mandible if mandibular fracture suspected)
- 120 kV; mAs per scanner with AEC; iterative reconstruction
- Reconstruct thin (0.5-0.75 mm) bone kernel; reformat coronal, sagittal, and 3D volume-rendered images for surgical planning
- Soft-tissue kernel series for orbital contents, soft-tissue injury, or contrast studies
- No breath-hold
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial bone | axial | 0.5-0.75 mm | Sharp kernel; reformat source |
| 2 | Coronal reformat (bone) | coronal | 1-2 mm | Orbital floor, maxillary walls |
| 3 | Sagittal reformat (bone) | sagittal | 1-2 mm | Orbital floor blowout, palate |
| 4 | 3D volume-rendered | 3D | n/a | Surgical planning, displaced fragments |
| 5 | Axial/coronal soft tissue | axial | 2-3 mm | Orbital contents, muscle entrapment, contrast enhancement if used |
Key points
- Non-contrast thin-section bone protocol with multiplanar + 3D reformats is the trauma standard
- Coronal plane critical for orbital floor blowout and inferior rectus entrapment; sagittal for orbital roof/floor
- Add IV contrast + soft-tissue series for suspected cellulitis/abscess, osteomyelitis, or neoplasm
- Exclude/clear cervical spine separately in polytrauma; check for associated globe injury and orbital emphysema
References
• ACR–ASNR–SPR Practice Parameter for the Performance of CT of the Extracranial Head and Neck
• ACR Appropriateness Criteria: Maxillofacial Trauma / Orbits Vision and Visual Loss
• Radiopaedia: CT facial bones (protocol) link
• RadioGraphics: Imaging of Facial Trauma
• ACR Appropriateness Criteria: Maxillofacial Trauma / Orbits Vision and Visual Loss
• Radiopaedia: CT facial bones (protocol) link
• RadioGraphics: Imaging of Facial Trauma
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.