Division of Veterinary Clinical Science, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, UK.
Equine Vet J. 2011 Mar;43(2):170-8. doi: 10.1111/j.2042-3306.2010.00148.x. Epub 2010 Aug 23.
Radiography is commonly used for the diagnosis of equine cheek teeth (CT) infection but, to our knowledge, no study to date has evaluated the relative values of individual specific radiographic signs when making a diagnosis.
To investigate the sensitivity and specificity of individual radiographic signs identified from the literature for the diagnosis of CT apical infection using a retrospective case-control study.
Cropped radiographs taken using computed radiography of 41 apically infected CT and 41 control CT were independently blindly evaluated by 3 clinicians for the presence of 12 predetermined radiographic signs associated with CT apical infection. A final diagnosis of either noninfected or infected was made. Sensitivity and specificity were calculated for the presence or absence of each radiographic sign for each clinician. Uni- and multivariable conditional logistic regression were used to determine strength of association of the 12 radiographic signs with apical infection.
Median sensitivity and specificity for the diagnosis of CT apical infection were 76 and 90%, respectively. Periapical sclerosis, clubbing of one or 2 roots, degree of clubbing and periapical halo formation had the highest sensitivities (73-90%), with moderate specificity (61-63%). Multivariable conditional logistic regression revealed that severity of periapical sclerosis and extensive periapical halo were strongly associated with CT apical infection.
The presence of periapical sclerosis and formation of a periapical halo were strongly associated with CT apical infection. Computed radiography appears to have a higher sensitivity but similar specificity to previously published results using film radiography to detect CT apical infection.
These findings may aid practitioners when interpreting radiographs of equine CT as to the relative significance of their findings.
放射学常用于马属动物颊齿（CT）感染的诊断，但据我们所知，目前尚无研究评估在做出诊断时，个体特定放射学征象的相对价值。
通过回顾性病例对照研究，调查从文献中确定的个别放射学征象在诊断 CT 根尖感染中的敏感性和特异性。
使用计算机放射摄影术对 41 个根尖感染的 CT 和 41 个对照 CT 拍摄的裁剪放射照片，由 3 位临床医生独立盲法评估 12 个与 CT 根尖感染相关的预定放射学征象的存在情况。对每个病例做出非感染或感染的最终诊断。计算每位临床医生每个放射学征象的存在或缺失的敏感性和特异性。使用单变量和多变量条件逻辑回归来确定 12 个放射学征象与根尖感染的关联强度。
诊断 CT 根尖感染的中位数敏感性和特异性分别为 76%和 90%。根尖硬化、1 或 2 个根的变钝、变钝程度和根尖晕环形成具有最高的敏感性（73-90%），特异性中等（61-63%）。多变量条件逻辑回归显示，根尖硬化的严重程度和广泛的根尖晕环与 CT 根尖感染密切相关。
根尖硬化和根尖晕环的形成与 CT 根尖感染密切相关。与使用胶片放射摄影术检测 CT 根尖感染的先前发表的结果相比，计算机放射摄影术似乎具有更高的敏感性和相似的特异性。
这些发现可能有助于临床医生在解释马属动物 CT 的放射照片时，了解其发现的相对重要性。
