Çağırankaya Leyla Berna, Akkaya Nursel, Akçiçek Gökçen, Boyacıoğlu Doğru Hatice
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Imaging Sci Dent. 2018 Jun;48(2):121-125. doi: 10.5624/isd.2018.48.2.121. Epub 2018 Jun 19.
Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard.
A total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. values <.05 were considered to indicate statistical significance.
Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and <.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively.
In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.
在全景X线片上检测喉软骨（麦粒软骨和甲状软骨）很重要，因为它们可能与分叉区域的颈动脉钙化相混淆，而颈动脉钙化是中风的一个危险因素。本研究以锥形束计算机断层扫描（CBCT）作为参考标准，评估全景X线摄影在诊断钙化喉软骨方面的有效性。
对170例患者（140例男性，30例女性）的312个区域（142个双侧区域，10个左侧区域，18个右侧区域）进行了检查。由一位有11年经验的口腔颌面放射科医生检查全景X线片。另外两位口腔颌面放射科医生对CBCT扫描进行了评估。计算kappa系数（κ）以确定观察者内部的一致性水平，并确定两种方法之间的一致性水平。还计算了诊断指标（敏感性、特异性、准确性以及假阳性和假阴性率）。P值<.05被认为具有统计学意义。
重新检查了82张图像以确定观察者内部的一致性水平，kappa系数计算为0.709（P<.05）。在全景X线片和CBCT图像之间发现了具有统计学意义且可接受的一致性（κ=0.684，P<.05）。全景X线片的敏感性、特异性、诊断准确率、假阳性率和假阴性率分别为85.4%、83.5%、84.6%、16.5%和14.6%。
在大多数情况下，可以在全景X线片上诊断出钙化的喉软骨。然而，由于钙化情况存在差异，诊断可能会有困难。
