Rosado Lucas de Paula Lopes, Barbosa Izabele Sales, de Aquino Sibele Nascimento, Junqueira Rafael Binato, Verner Francielle Silvestre
Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Department of Dentistry, Federal University of Juiz de Fora Governador Valadares Campus, Governador Valadares, Minas Gerais, Brazil.
Imaging Sci Dent. 2019 Sep;49(3):191-199. doi: 10.5624/isd.2019.49.3.191. Epub 2019 Sep 24.
To compare the diagnostic ability of undergraduate dental students to detect maxillary sinus abnormalities in panoramic radiographs (PR) and cone-beam computed tomography (CBCT).
This was a retrospective study based on the evaluation of PR and CBCT images. A pilot study was conducted to determine the number of students eligible to participate in the study. The images were evaluated by 2 students, and 280 maxillary sinuses were assessed using the following categories: normal, mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, antrolith, and antrolith associated with mucosal thickening. The reference standard was established by the consensus of 2 oral radiologists based on the CBCT images. The kappa test, receiver operating characteristic curves, and 1-way analysis of variance with the Tukey-Kramer post-hoc test were employed.
Intraobserver and interobserver reliability showed agreement ranging from substantial (0.809) to almost perfect (0.922). The agreement between the students' evaluations and the reference standard was reasonable (0.258) for PR and substantial (0.692) for CBCT. Comparisons of values of sensitivity, specificity, and accuracy showed that CBCT was significantly better (<0.05).
CBCT was better than PR for the detection of maxillary sinus abnormalities by dental students. However, CBCT should only be requested after a careful analysis of PR by students and more experienced professionals.
比较牙科本科学生在全景片(PR)和锥形束计算机断层扫描(CBCT)中检测上颌窦异常的诊断能力。
这是一项基于PR和CBCT图像评估的回顾性研究。进行了一项初步研究以确定有资格参与该研究的学生人数。图像由2名学生进行评估,共评估了280个上颌窦,评估类别如下:正常、黏膜增厚、鼻窦息肉、窦腔假性囊肿、非特异性混浊、骨膜炎、窦石以及与黏膜增厚相关的窦石。参考标准由2名口腔放射科医生根据CBCT图像达成共识确定。采用kappa检验、受试者工作特征曲线以及带有Tukey-Kramer事后检验的单向方差分析。
观察者内和观察者间可靠性显示一致性范围从高度一致(0.809)到几乎完全一致(0.922)。学生评估与参考标准之间的一致性,PR为中等(0.258),CBCT为高度一致(0.692)。敏感性、特异性和准确性值的比较表明,CBCT明显更好(<0.05)。
对于牙科学生检测上颌窦异常,CBCT比PR更好。然而,学生和经验更丰富的专业人员在仔细分析PR后才应要求使用CBCT。