超声、磁共振成像和锥形束计算机断层扫描在颌面部异物检测中的比较
Comparison of Ultrasonography, Magnetic Resonance Imaging and Cone Beam Computed Tomography for Detection of Foreign Bodies in Maxillofacial Region.
作者信息
Shokri Abbas, Jamalpour Mohammadreza, Jafariyeh Behrouz, Poorolajal Jalal, Sabet Negar Kanouni
机构信息
Assistant Professor, Dental Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
Associate Professor, Dental Research Center, Department of Oral and Maxillofacial Surgery, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
出版信息
J Clin Diagn Res. 2017 Apr;11(4):TC15-TC19. doi: 10.7860/JCDR/2017/24523.9736. Epub 2017 Apr 1.
INTRODUCTION
Foreign Bodies (FBs) entrapped in the maxillofacial region have a high prevalence due to trauma and accidents. Accurate localization of FBs and verifying their type and size are critical to assist the surgeon in their fast retrieval with minimal tissue damage.
AIM
To assess and compare the imaging modalities including MRI, ultrasonography and Cone Beam Computed Tomography (CBCT) for detection of different types of FBs.
MATERIALS AND METHODS
In this study, four types of FBs including pieces of normal glass, barium glass, wood and pebbles with equal sizes were placed randomly in two sheep heads in different locations such as upper lip, maxillary sinus and body of mandible as FBs and subjected to MRI, ultrasound and CBCT. The images were interpreted by expert observers and the data was analysed using the stata 11 software, kappa test and chi-square test.
RESULTS
Sensitivity of CBCT, MRI and ultrasound for detecting foreign bodies was 79.19%, 20.83% and 33.33%, respectively. None of the imaging modalities could clearly visualize wooden FBs. Among different FBs, pebbles and barium glass were detected more accurately by radiographic imaging technique. The sensitivity of CBCT, ultrasound and MRI for pebbles was 100%, 33.33% and 16.67%, respectively. The sensitivity of CBCT, ultrasound and MRI for barium glass was 100%, 33.33% and 41.69%, respectively. The sensitivity of CBCT, ultrasound and MRI for wood was 33.33%, 33.33% and 16.67%, respectively. Specificity of all three imaging modalities was 100%. Diagnostic accuracy of all three imaging modalities was higher for detection of FBs in the upper lip than those in the body of mandible, and FBs in the latter location had higher detection accuracy than those in the maxillary sinus.
CONCLUSION
Among the three imaging modalities, CBCT had the highest diagnostic sensitivity for the examined FBs. The highest diagnostic sensitivity was noted for pebbles and barium glass.
引言
由于创伤和事故，滞留在颌面区域的异物（FBs）很常见。准确确定异物的位置并核实其类型和大小对于帮助外科医生在对组织损伤最小的情况下快速取出异物至关重要。
目的
评估和比较包括磁共振成像（MRI）、超声检查和锥形束计算机断层扫描（CBCT）在内的成像方式对不同类型异物的检测能力。
材料与方法
在本研究中，将四种大小相等的异物，即普通玻璃碎片、钡玻璃碎片、木块和鹅卵石，随机放置在两只羊头部的不同位置，如上唇、上颌窦和下颌体，然后对其进行MRI、超声和CBCT检查。由专业观察者解读图像，并使用Stata 11软件、kappa检验和卡方检验对数据进行分析。
结果
CBCT、MRI和超声检测异物的灵敏度分别为79.19%、20.83%和33.33%。没有一种成像方式能够清晰显示木块。在不同的异物中，鹅卵石和钡玻璃通过放射成像技术检测得更准确。CBCT、超声和MRI检测鹅卵石的灵敏度分别为100%、33.33%和16.67%。CBCT、超声和MRI检测钡玻璃的灵敏度分别为100%、33.33%和41.69%。CBCT、超声和MRI检测木块的灵敏度分别为33.33%、33.33%和16.67%。三种成像方式的特异性均为100%。对于检测上唇的异物，三种成像方式的诊断准确性均高于下颌体的异物，而后一位置的异物检测准确性高于上颌窦的异物。
结论
在三种成像方式中，CBCT对所检查的异物具有最高的诊断灵敏度。对鹅卵石和钡玻璃的诊断灵敏度最高。
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