Honey Oana Bida, Scarfe William Charles, Hilgers Michael J, Klueber Kathleen, Silveira Anibal M, Haskell Bruce S, Farman Allan G
University of Louisville, Louisville, KY 40292, USA.
Am J Orthod Dentofacial Orthop. 2007 Oct;132(4):429-38. doi: 10.1016/j.ajodo.2005.10.032.
Cone-beam computed tomography (CBCT) is increasingly being used as an imaging modality, particularly in the assessment of the temporomandibular joint (TMJ). A blinded observational cross-sectional in-vitro study was conducted to compare the diagnostic accuracy of observers viewing images made with CBCT, panoramic radiography, and linear tomography. The task was to detect cortical erosions affecting the mandibular condylar head.
The sample consisted of 37 TMJ articulations from 30 skulls with either normal condylar morphology (n = 19) or erosion of the lateral pole (n = 18). The articulations were imaged by using corrected angle linear tomography (TOMO), normal (Pan-N) and TMJ-specific (Pan-TM) panoramic radiography, and CBCT. Digital images were obtained with photostimulable phosphor plates for all modalities except CBCT. The CBCT detector used an amorphous silicon flat-panel array combined with cesium iodide. Images and 10 rereads were presented to 10 observers on a flat-panel display at a pixel-to-monitor ratio of 1:1. CBCT multi-planar images were presented both statically (CBCT-S) and interactively (CBCT-I). The observers were permitted to scroll through axial (0.4 mm) and para-sagittal (1 mm) sections and then independently rate their confidence about the presence or absence of cortical erosion. Intraobserver reliability was determined by weighted kappa and diagnostic accuracy by the fitted area under the ROC curve. Means were compared by using ANOVA (P < or =.05).
Intraobserver reliability was moderate (0.57 +/- 0.22; range, 0.34-0.78). Pan-N (0.72 +/- 0.15), CBCT-I (0.65 +/- 0.21), and CBCT-S (0.65 +/- 0.17) reliability was significantly greater than TOMO (0.44 +/- 0.25). The diagnostic accuracy of CBCT-I (0.95 +/- 0.05) and CBCT-S (0.77 +/- 0.17) was significantly greater than all other modalities (Pan-N [0.64 +/- 0.11], Pan-TM [0.55 +/- 0.11], TOMO [0.58 +/- 0.15]). CBCT-I was also more accurate than CBCT-S, and Pan-N was more accurate than Pan-TM and TOMO.
CBCT images provide superior reliability and greater accuracy than TOMO and TMJ panoramic projections in the detection of condylar cortical erosion.
锥束计算机断层扫描（CBCT）越来越多地被用作一种成像方式，尤其是在颞下颌关节（TMJ）的评估中。进行了一项双盲观察性横断面体外研究，以比较观察者查看CBCT、全景X线摄影和线性断层扫描所成图像的诊断准确性。任务是检测影响下颌髁突头部的皮质侵蚀。
样本包括来自30个颅骨的37个TMJ关节，其中髁突形态正常（n = 19）或外侧极侵蚀（n = 18）。使用校正角度线性断层扫描（TOMO）、普通（Pan-N）和TMJ特异性（Pan-TM）全景X线摄影以及CBCT对关节进行成像。除CBCT外，所有模态均使用光激励荧光板获得数字图像。CBCT探测器使用非晶硅平板探测器与碘化铯组合。图像和10次重新读取的图像以1:1的像素与显示器比例在平板显示器上呈现给10名观察者。CBCT多平面图像以静态（CBCT-S）和交互式（CBCT-I）两种方式呈现。观察者可以滚动浏览轴向（0.4毫米）和矢状旁（1毫米）层面，然后独立评估他们对皮质侵蚀存在与否的信心。观察者内可靠性通过加权kappa系数确定，诊断准确性通过ROC曲线下拟合面积确定。采用方差分析比较均值（P≤0.05）。
观察者内可靠性为中等（0.57±0.22；范围为0.34 - 0.78）。Pan-N（0.72±0.15）、CBCT-I（0.65±0.21）和CBCT-S（0.65±0.17）的可靠性显著高于TOMO（0.44±0.25）。CBCT-I（0.95±0.05）和CBCT-S（0.77±0.17）的诊断准确性显著高于所有其他模态（Pan-N [0.64±0.11]、Pan-TM [0.55±0.11]、TOMO [0.58±0.15]）。CBCT-I也比CBCT-S更准确，Pan-N比Pan-TM和TOMO更准确。
在检测髁突皮质侵蚀方面，CBCT图像比TOMO和TMJ全景投影具有更高的可靠性和准确性。
Zotero 插件