Comparative Evaluation of Digital Radiography versus Conventional Radiography of Fractured Skulls

Abstract

The authors assessed the relative efficacy of conventional and digital storage-phosphor radiographs for the detection of skull fractures. Fifty conventional film-screen radiographs (FSR) and 50 digital storage-phosphor radiographs (DR) with 66 fractures were compared. Five radiologists evaluated image quality and fracture detectability. The results were analyzed by receiver operating characteristic (ROC) curve analysis. With a standard exposure, the ability to evaluate skull fractures was equally good with either technique (ROC area for DR, 0.8954; for FSR, 0.8870). Digital radiography was superior in evaluating nasal bone. For petrosal bone, the DR image simulates an underexposure. This disadvantage compared with FSR can be compensated by image postprocessing. In evaluation of skull fractures, radiologists performance with DR is equivalent to FSR.