8 Imaging techniques, including computed tomography-guided biopsy and FDG-PET

and 99mTc-HMPAO-labelled
leukocytes together with 67Ga-gallium citrate for the
diagnosis and localization of infection or inflammation
in soft tissues.
3 99mTc-pertechnetate for dynamic salivary gland imaging
or to detect ectopic thyroid tissue.

111Indium-labelled

IMAGING IN DIFFERENT CLINICAL SCENARIOS

Tables 1.1.51.1.16 and Figures 1.1.71.1.14 provide
information on imaging in different clinical scenarios.

Table 1.1.5 Imaging of craniofacial malformations and craniosynostosis.

Imaging modality

Imaging issues

Radiography: OPG,
cephalometry, skull series

Comment
Isolated sagittal, metopic or unilateral coronal synostosis may be confirmed
with radiography

Low dose CT 3D data

(cranial or craniofacial)
with post-processing

Define foci of sutural synostosis

for surgical planning
3D assessment of facial deformity
and orofacial clefts

Cranial CT/CTV/MRI

Detect intracranial malformations

and venous stenosis in the setting
of complex synostosis

CT with post-processing is more definitive and superior for defining foci of

sutural closure. Required for surgical planning and for assessment of
complex craniofacial anomalies/petrous temporal bone anomalies
3D data set may be used for preoperative surgical stimulation with
stereolithography or fused deposition modelling

CT, computed tomography; CTV, computed tomography venogram; MRI, magnetic resonance imaging.

Table 1.1.6 Imaging of facial/craniofacial trauma.

Imaging modality
Radiographs:
Standard midfacial series is OM,
OM 15/30 and lateral

Imaging issues

Comment

Screen for fractures and assess need

for further CT
`

Most uncomplicated zygomatic, orbital and mandibular injuries

may be evaluated with plain radiography alone

Standard mandibular series is OPG

(lateral obliques if not
available/impractical) and frontal
Low dose CT with 3D post
processing

Delineate extent and displacement of Always consider intracranial and cervical spine imaging in the
fractures
early management of high energy facial injury

Standard CT

Review key sites, e.g. displaced

fractures of frontal sinus posterior
wall

CT is also required for suspected craniofacial injury or when

there is orbital dysfunction (Figure 1.1.7), fractures are
severe/comminuted or as a precursor to surgery
Standard (non low dose) CT may be used to evaluate orbital or
cranial soft tissue complications
3D data set post processing may be used for modeling of
implants and to aid surgical planning in patients with complex
fracture geometry (Figure 1.1.8)

MRI

Soft tissue (including intracranial)

complications

Others: ocular ultrasound,

dacrocystography, sialography,
CT cisternography

Soft tissue complications

CT, computed tomography; MRI, magnetic resonance imaging.

Selected cases depending on clinical findings