Department of Oral Medicine and Radiology, Thai Moogambigai Dental College, Chennai, India;
Dentomaxillofac Radiol. 2013;42(9):20120319. doi: 10.1259/dmfr.20120319. Epub 2013 Aug 1.
To characterize the sonographic features of the buccal mucosa in patients with oral submucous fibrosis (OSF).
Three groups (controls with areca-related habits, controls without areca-related habits and clinically diagnosed OSF cases), each comprising 30 subjects, were included in the study. After a thorough clinical examination, transcutaneous B-mode ultrasonography was performed with a multifrequency linear transducer (5-10 MHz) for anterior and posterior buccal mucosa bilaterally. Both clinical and ultrasound findings were recorded by three independent observers. One-way analysis of variance and Tukey's honestly significant difference post-hoc tests were used for statistical comparisons between groups and Pearson χ(2) tests to compare the proportions. Kappa statistics was used to determine the interobserver agreement.
The submucosa that appeared hypoechoic in the control groups had significantly increased echogenicity in the case group (hypo- to isoechoic in 46.7% and isoechoic in 53.3%). The differentiation between the submucosa and the muscle layer appeared distinct in the control groups while it was not clear in the case group (indistinct in 50% and completely lost in 50%). The number of sites found positive on the ultrasound was significantly greater than the number of clinically positive sites. There was a very good interobserver consistency in clinical and ultrasound findings.
Ultrasonography of the buccal mucosa demonstrates increased submucosal echogenicity and reduced echo differentiation between submucosa and muscle layer in OSF cases. Hence, it can be used as a non-invasive imaging modality to assess the disease extent and severity across the entire buccal mucosa to supplement clinical evaluation.
描述口腔黏膜下纤维性变（OSF）患者颊黏膜的超声特征。
本研究纳入了三组患者（与槟榔相关习惯的对照组、无槟榔相关习惯的对照组和临床诊断为 OSF 的病例组，每组各 30 例）。在进行彻底的临床检查后，使用多频线性探头（5-10MHz）对双侧颊黏膜进行经皮 B 型超声检查。由三位独立观察者记录临床和超声检查结果。采用单因素方差分析和 Tukey Honestly Significant Difference 事后检验比较组间差异，采用 Pearson χ²检验比较比例，采用 Kappa 统计检验评估观察者间一致性。
对照组中呈低回声的黏膜下组织在病例组中表现出明显更高的回声强度（46.7%为低-等回声，53.3%为等回声）。对照组中黏膜下组织与肌肉层的分界清晰，而病例组中分界不清晰（50%为分界不清，50%完全消失）。超声检查阳性的部位数量明显多于临床阳性的部位数量。临床和超声检查结果具有很好的观察者间一致性。
颊黏膜超声检查显示 OSF 病例的黏膜下回声增强，黏膜下组织与肌肉层的回声分界减弱。因此，它可以作为一种非侵入性的影像学方法，用于评估整个颊黏膜的疾病程度和严重程度，以补充临床评估。
