体内使用二维传统方法和从容积再现程序重建的三维锥形束 CT 图像进行线性和角度测量的比较。
Comparison of linear and angular measurements using two-dimensional conventional methods and three-dimensional cone beam CT images reconstructed from a volumetric rendering program in vivo.
机构信息
Department of Orthodontics, Near East University, Mersin, Turkey.
出版信息
Dentomaxillofac Radiol. 2011 Dec;40(8):492-500. doi: 10.1259/dmfr/15644321.
OBJECTIVE
The aim of this study was to compare the linear and angular measurements made on two-dimensional (2D) conventional cephalometric images and three-dimensional (3D) cone beam CT (CBCT) generated cephalograms derived from a 3D volumetric rendering program.
METHODS
Pre-treatment cephalometric digital radiographs of 11 patients and their corresponding CBCT images were randomly selected. The digital cephalometric radiographs were traced using Vista Dent OC (GAC International, Inc Bohemia, NY) and by hand. CBCT and Maxilim® (Medicim, Sint-Niklass, Belgium) software were used to generate cephalograms from the CBCT data set that were then linked to the 3D hard-tissue surface representations. In total, 16 cephalometric landmarks were identified and 18 widely used measurements (11 linear and 7 angular) were performed by 2 independent observers. Intraobserver reliability was assessed by calculating intraclass correlation coefficients (ICC), interobserver reliability was assessed with Student t-test and analysis of variance (ANOVA). Mann-Whitney U-tests and Kruskal-Wallis H tests were also used to compare the three methods (P < 0.05).
RESULTS
The results demonstrated no statistically significant difference between interobserver analyses for CBCT-generated cephalograms (P < 0.05), except for Gonion-Menton (Go-Me) and Condylion-Gnathion (Co-Gn). Intraobserver examinations showed low ICCs, which was an indication of poor reproducibility for Go-Me and Sella-Nasion (S-N) in CBCT-generated cephalograms and poor reproducibility for Articulare-Gonion (Ar-Go) in the 2D hand tracing method (P < 0.05). No statistical significance was found for Vista Dent OC measurements (P > 0.05).
CONCLUSIONS
Measurements from in vivo CBCT-generated cephalograms from Maxilim® software were found to be similar to conventional images. Thus, owing to higher radiation exposure, CBCT examinations should only be used when the inherent 3D information could improve the outcome of treatment.
目的
本研究旨在比较二维（2D）传统头颅侧位片和三维（3D）锥形束 CT（CBCT）生成的头颅侧位片的线性和角度测量值，这些图像均来自三维容积渲染程序。
方法
随机选取 11 例患者的治疗前头颅侧位数字射线照片及其相应的 CBCT 图像。使用 Vista Dent OC（GAC International，Inc Bohemia，NY）和手工对数字头颅侧位射线照片进行描记。使用 CBCT 和 Maxilim®（Medicim，Sint-Niklass，比利时）软件从 CBCT 数据集生成头颅侧位片，然后将其与三维硬组织表面表示相关联。总共确定了 16 个头颅测量标志点，并由 2 名独立观察者进行了 18 项广泛使用的测量（11 项线性和 7 项角度测量）。通过计算组内相关系数（ICC）评估观察者内可靠性，通过学生 t 检验和方差分析（ANOVA）评估观察者间可靠性。还使用 Mann-Whitney U 检验和 Kruskal-Wallis H 检验比较了 3 种方法（P<0.05）。
结果
结果表明，除了下颌角-下颌颏（Go-Me）和髁突-下颌颏（Co-Gn），CBCT 生成的头颅侧位片中观察者间分析无统计学差异（P<0.05）。观察者内检查显示低 ICC，表明 CBCT 生成的头颅侧位片中下颌角-下颌颏（Go-Me）和蝶鞍-鼻根（S-N）的可重复性差，二维手工描记方法中下颌关节-下颌角（Ar-Go）的可重复性差（P<0.05）。Vista Dent OC 测量值无统计学差异（P>0.05）。
结论
发现 Maxilim®软件生成的体内 CBCT 头颅侧位片的测量值与传统图像相似。因此，由于辐射暴露量较高，仅在固有 3D 信息可以改善治疗效果时，才应使用 CBCT 检查。
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