Naser Asieh Zamani, Shirani Amir Mansour, Hekmatian Ehsan, Valiani Ali, Ardestani Pegah, Vali Ava
Associate Professor, Department of Oral and Maxillofacial Radiology and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Dent Res J (Isfahan). 2010 Summer;7(2):76-81.
Radiographic examination of TMJ is indicated when there are clinical signs of pathological conditions, mainly bone changes that may influence the diagnosis and treatment planning. The purpose of this study was to evaluate and to compare the validity and diagnostic accuracy of uncorrected and corrected sagittal tomographic images in the detection of simulated mandibular condyle erosions.
Simulated lesions were created in 10 dry mandibles using a dental round bur. Using uncorrected and corrected sagittal tomography techniques, mandibular condyles were imaged by a Cranex Tome X-ray unit before and after creating the lesions. The uncorrected and corrected tomography images were examined by two independent observers for absence or presence of a lesion. The accuracy for detecting mandibular condyle lesions was expressed as sensitivity, specificity, and validity values. Differences between the two radiographic modalities were tested by Wilcoxon for paired data tests. Inter-observer agreement was determined by Cohen's Kappa.
The sensitivity, specificity and validity were 45%, 85% and 30% in uncorrected sagittal tomographic images, respectively, and 70%, 92.5% and 60% in corrected sagittal tomographic images, respectively. There was a significant statistical difference between the accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions (P = 0.016). The inter-observer agreement was slight for uncorrected sagittal tomography and moderate for corrected sagittal tomography.
The accuracy of corrected sagittal tomography is significantly higher than that of uncorrected sagittal tomography. Therefore, corrected sagittal tomography seems to be a better modality in detection of mandibular condyle erosions.
当存在病理状况的临床体征时，主要是可能影响诊断和治疗计划的骨改变时，需对颞下颌关节进行影像学检查。本研究的目的是评估和比较未校正和校正矢状断层图像在检测模拟下颌髁突侵蚀方面的有效性和诊断准确性。
使用牙科圆钻在10个干燥下颌骨上制造模拟病变。使用未校正和校正矢状断层扫描技术，在制造病变前后，用Cranex Tome X射线装置对下颌髁突进行成像。两名独立观察者检查未校正和校正的断层图像，以确定是否存在病变。检测下颌髁突病变的准确性用敏感性、特异性和有效性值表示。两种影像学方法之间的差异通过配对数据的Wilcoxon检验进行测试。观察者间的一致性通过Cohen's Kappa确定。
未校正矢状断层图像的敏感性、特异性和有效性分别为45%、85%和30%，校正矢状断层图像的敏感性、特异性和有效性分别为70%、92.5%和60%。未校正和校正矢状断层扫描在检测下颌髁突侵蚀的准确性方面存在显著统计学差异（P = 0.016）。未校正矢状断层扫描的观察者间一致性轻微，校正矢状断层扫描的观察者间一致性中等。
校正矢状断层扫描的准确性显著高于未校正矢状断层扫描。因此，校正矢状断层扫描似乎是检测下颌髁突侵蚀的更好方法。
