Nakayama E, Yoshiura K, Yuasa K, Tabata O, Araki K, Kanda S, Ozeki S, Shinohara M
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
Dentomaxillofac Radiol. 1999 Nov;28(6):351-6. doi: 10.1038/sj/dmfr/4600480.
To assess the diagnostic accuracy of panoramic radiography (PR), panoramic radiography combined with intraoral radiography (PR+IR), and CT in detecting the supero-inferior extent of tumor invasion of the mandible by gingival carcinoma.
PR, PR+IR, and CT images of the mandible in 37 patients with gingival carcinoma were evaluated by five oral radiologists for the supero-inferior extent of bone invasion using ROC analysis. The mean ROC curve area (Az) of each observer for the different imaging modalities was analysed by nonparametric two-way ANOVA. P<0.05 was considered statistically significant.
The mean Az for the detection of bone invasion were 0.88+/-0.03 for PR, 0.77+/-0.12 for PR+IR, and 0.87+/-0.03 for CT (P=0.0907). The mean Az for the detection of bone invasion beyond the alveolus was 0.89+/-0.07 for PR, 0.85+/-0.08 for PR+IR, and 0.83+/-0.06 for CT (P=0.5438). The mean Az for the detection of bone invasion beneath the mandibular canal were 0.94+/-0.04 for PR, 0.94+/-0.02 for PR+IR, and 0.91+/-0. 04 for CT (P=0.2466). No statistically significant differences were observed in Az between PR, PR+IR, and CT.
We consider that PR+IR should be adopted as the initial imaging modality to determine the extent of supero-inferior invasion of the mandible in gingival carcinoma.
评估全景X线片（PR）、全景X线片联合口内X线片（PR+IR）及CT在检测牙龈癌下颌骨肿瘤侵犯上下范围方面的诊断准确性。
37例牙龈癌患者的下颌骨PR、PR+IR及CT图像由5名口腔放射科医生使用ROC分析评估骨侵犯的上下范围。采用非参数双向方差分析分析不同成像方式下各观察者的平均ROC曲线面积（Az）。P<0.05被认为具有统计学意义。
PR检测骨侵犯的平均Az为0.88±0.03，PR+IR为0.77±0.12，CT为0.87±0.03（P=0.0907）。PR检测牙槽以外骨侵犯的平均Az为0.89±0.07，PR+IR为0.85±0.08，CT为0.83±0.06（P=0.5438）。PR检测下颌管以下骨侵犯的平均Az为0.94±0.04，PR+IR为0.94±0.02，CT为0.91±0.04（P=0.2466）。PR、PR+IR和CT之间的Az未观察到统计学显著差异。
我们认为PR+IR应作为确定牙龈癌下颌骨上下侵犯范围的初始成像方式。
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