School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.
School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Int Dent J. 2024 Aug;74(4):808-815. doi: 10.1016/j.identj.2023.11.013. Epub 2023 Dec 23.
This project aims to determine the prevalence of cone-beam computed tomography (CBCT) findings requiring referral. Additionally, the goal is to establish a reference standard protocol for incidental findings, outlining indications for further investigation and management protocol.
Patients records from the Advanced Imaging Centre at the School of Dentistry, University of Alberta, underwent systematic examination to identify CBCT incidental findings. Radiographic findings requiring referral were categorised into 8 anatomic zones. Analysis assessed prevalence and a management protocol was developed for significant findings. Inferential analyses were conducted to determine the frequency and prevalence of specific findings requiring further investigation.
A total of 1260 CBCT interpretive reports were analysed. The most prevalent radiographic findings outside the areas of interest were found in the cervical vertebrae (18%), followed by the sinuses (15%), temporomandibular joints (8%), jaw lesions (7%), airway (5%), teeth (5%), soft tissue calcifications (5%), and other (1%).
Findings most commonly requiring external referral included carotid atheroma (2.7%), cervical vertebrae osteoarthritis (0.97%), jaw lesions (0.86%), adenoid and/or tonsillar hypertrophy (0.86%), and paranasal sinus pathology (0.73%). Increased medicolegal awareness and practitioner knowledge contribute to the rising number of CBCT-identified radiographic findings outside the area of concern. The study addresses the debate on reporting all CBCT/radiographic findings by exploring their prevalence and providing protocols. These guidelines assist dentists in identification, decision-making, and referral processes.
本项目旨在确定需要转诊的锥形束 CT（CBCT）检查结果的患病率。此外，还旨在制定偶然发现的参考标准方案，列出进一步检查的指征和管理方案。
对艾伯塔大学牙科学院先进影像中心的患者记录进行系统检查，以确定 CBCT 偶然发现。将需要转诊的影像学发现分为 8 个解剖区域。分析评估了患病率，并为有意义的发现制定了管理方案。进行推理分析以确定需要进一步调查的特定发现的频率和患病率。
共分析了 1260 份 CBCT 解释报告。在关注区域之外，最常见的放射学发现是颈椎（18%），其次是鼻窦（15%）、颞下颌关节（8%）、颌骨病变（7%）、气道（5%）、牙齿（5%）、软组织钙化（5%）和其他（1%）。
最常需要外部转诊的发现包括颈动脉粥样硬化（2.7%）、颈椎骨关节炎（0.97%）、颌骨病变（0.86%）、腺样体和/或扁桃体肥大（0.86%）和副鼻窦病变（0.73%）。医疗法律意识和从业者知识的提高导致 CBCT 识别的关注区域外的放射学发现数量增加。本研究通过探讨其患病率并提供方案，解决了报告所有 CBCT/放射学发现的争论。这些指南有助于牙医进行识别、决策和转诊过程。
