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Purpose: The purpose of this study is to compare the accuracy of facial linear measurements obtained from volumetric spiral CT using 2D versus 3D reconstruction, and test the repeatability of these measurements. Material and Methods: The population consisted of 5 cadaver heads that were scanned to a Spiral CT scanner (120 Kvp and 200 mA, Toshiba Xpress S/X Toshiba-America, Medical System Inc., Tustin, CA) with high- resolution contiguous slices. Heads were scanned with 3 mm thick axial slices and a 2 mm/sec table feed. The CT data were archived on optical disks, and then transferred to a networked computer workstation (Sun Microsystems with Cemax version 1.4 software, Fremont, CA), to generate 2D and 3D images for manipulation and analyses. Repeated measurements were done on 2D and 3D images reconstructed from spiral CT scans on the workstation. Linear measurements were done by 2 observers with 2 sessions each, using several unique and conventional craniometric anatomic landmarks. The soft tissues were then partially removed and physical measurements of the same landmarks were repeated by an electromagnetic (3 space) digitizer (Polhemus Navigation Sciences Division, Mc Donnell Douglas Electronic Company, Colchester, VE). Analyses of variance were done to compare 2D versus 3D methods, and the accuracy of measurements between both imaging techniques. Results: The results showed statistically significant differences between 2D and 3D images for the majority of measurements. The 3D image measurements were not statistically different from the physical measurements. However, some of the 2D image landmarks differed from physical measurements. The repeatability of measurements was high by spiral CT-based craniofacial imaging. Conclusion: New computer graphics technology combined with 3D volumetric imaging by spiral CT can distinguish the craniofacial anatomy with greater accuracy than previously reported measurements and with greater accuracy than measurements from 2DCT images. These 3D measurements are essential to diagnostic and treatment planning of craniofacial injuries, anomalies and for craniofacial identification.
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