Horner Keith, Karayianni Kety, Mitsea Anastasia, Berkas Leonidas, Mastoris Michael, Jacobs Reinhilde, Lindh Christina, van der Stelt Paul, Marjanovic Elizabeth, Adams Judith, Pavitt Susan, Devlin Hugh
School of Dentistry, University of Manchester, Manchester, UK.
J Clin Densitom. 2007 Apr-Jun;10(2):138-46. doi: 10.1016/j.jocd.2007.02.004. Epub 2007 Apr 20.
The aim of this study was to measure the accuracy of porosity of the mandibular cortex on dental panoramic radiographs (DPRs) in diagnosis of osteoporosis, alone and in combination with a clinical risk index. Six hundred seventy-one women (45-70yr) were recruited in the study, and dual-energy X-ray absorptiometry of the hip and lumbar spine was performed. A clinical index of osteoporosis risk (OSIRIS) and a DPR were obtained for each subject. The cortical appearance on the DPR was classified using the mandibular cortical index (MCI) by 5 observers. receiver operating characteristic (ROC) curve analysis was performed with calculation of area under the ROC curve (AUC) and sensitivity and specificity at various thresholds. Complete data were available for 653 subjects, of whom 21.6% had osteoporosis. The AUC for OSIRIS was 0.838. When used alone as the diagnostic test, MCI AUC for the 5 observers ranged from 0.560 to 0.670, significantly less than OSIRIS. Intraobserver and interobserver repeatability of MCI assessment was inconsistent. We conclude that MCI has limited value for osteoporosis diagnosis, being most appropriate as a method of fortuitous case-finding.
本研究的目的是测量牙科全景X线片（DPR）上下颌骨皮质孔隙率在骨质疏松症诊断中的准确性，以及单独使用和与临床风险指数联合使用时的准确性。本研究招募了671名45至70岁的女性，并对其髋部和腰椎进行了双能X线吸收测定。为每位受试者获取骨质疏松症风险临床指数（OSIRIS）和一张DPR。由5名观察者使用下颌骨皮质指数（MCI）对DPR上的皮质外观进行分类。进行了受试者操作特征（ROC）曲线分析，计算了ROC曲线下面积（AUC）以及不同阈值下的敏感性和特异性。653名受试者获得了完整数据，其中21.6%患有骨质疏松症。OSIRIS的AUC为0.838。单独作为诊断测试时，5名观察者的MCI AUC范围为0.560至0.670，显著低于OSIRIS。MCI评估的观察者内和观察者间重复性不一致。我们得出结论，MCI在骨质疏松症诊断中的价值有限，最适合作为一种偶然发现病例的方法。
