Raitz R, Correa L, Curi Mm, Dib Ll, Fenyo-Pereira M
Rua Heitor Penteado, 1832. cj 101 A, São Paulo, SP, CEP 05438-300, Brazil.
Dentomaxillofac Radiol. 2006 May;35(3):165-9. doi: 10.1259/dmfr/49307329.
To compare the diagnostic processes for the main unilocular radiolucent lesions of the mandible in the presence of the following variables: conventional and digital radiography, specialization of the examiner and type of lesion.
Twenty-four panoramic radiographs were selected from the archives of the AC Camargo Hospital (São Paulo, Brazil), aiming at comparing the diagnostic processes for similar unilocular radiolucent lesions of the mandible, with the following histopathological diagnosis: six ameloblastomas, six dentigerous cysts, six keratocysts and six traumatic bone cysts. The radiographs were scanned and processed using the Trophy 2000 software. Three specialists, each from four related areas (pathologists, stomatologists, radiologists and oral surgeons), randomly evaluated the radiographs before and after digitalization.
The kappa statistic showed a high level of agreement between results obtained using the two radiographic techniques. This means that, in general, the examiners diagnosed the same cases correctly or incorrectly regardless of the method used.
Based on generalized estimating equations, it was concluded that the probability of correct diagnosis does not depend on the kind of lesion, on the radiographic technique or on the specialization of the examiner. In view of the differing opinions of the specialists regarding the diagnostic validity of some software features available and of the results obtained in indirect digital technique, it may be reasonable to reconsider its use for diagnosis of bone pathology.
比较在下述变量存在的情况下,下颌骨主要单房性透射性病变的诊断过程:传统放射摄影与数字放射摄影、检查者的专业领域以及病变类型。
从AC卡马戈医院(巴西圣保罗)的档案中选取24张全景放射照片,旨在比较下颌骨类似单房性透射性病变的诊断过程,其组织病理学诊断如下:6例成釉细胞瘤、6例含牙囊肿、6例角化囊肿和6例创伤性骨囊肿。使用Trophy 2000软件对放射照片进行扫描和处理。三名分别来自四个相关领域(病理学家、口腔医师、放射科医师和口腔外科医生)的专家,在数字化前后随机评估这些放射照片。
kappa统计量显示,使用两种放射摄影技术获得的结果之间具有高度一致性。这意味着,总体而言,无论使用何种方法,检查者对相同病例的诊断正确或错误情况相同。
基于广义估计方程,得出的结论是,正确诊断的概率不取决于病变类型、放射摄影技术或检查者的专业领域。鉴于专家们对某些可用软件功能的诊断有效性以及间接数字技术所获结果存在不同意见,重新考虑将其用于骨病理学诊断可能是合理的。