School of Dental Medicine, Center for Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11 000, Serbia.
Head Face Med. 2024 Sep 28;20(1):54. doi: 10.1186/s13005-024-00458-6.
The incisive foramen width was a traditional imaging criterion for diagnosing nasopalatine duct (NPD) cysts. Recent CBCT studies demonstrated significant dimensional variations of the nasopalatine canal, which raised questions about the accuracy of this criterion. This study investigated whether nasopalatine canal diameters assessed on CBCT images can accurately differentiate NPD cysts from normal nasopalatine canals.
The study included 19 patients with NPD cysts (12 (63.2%) males, 7 (36.8%) females, mean age 44.7 ± 13.3), and a control group of 164 patients (72 (43.9%) males, 92 (56.1%) females, mean age 47.25 ± 17.74). CBCT images were retrospectively evaluated. The following nasopalatine canal diameters were measured on reference sagittal, coronal, and axial reformation images: nasal opening anteroposterior (AP) and mediolateral (ML) diameter, oral opening AP (APOO) and ML (MLOO) diameter, nasopalatine canal length, minimum ML (minML) diameter, anterior wall expansion (AWE), nasopalatine canal angle, and the mid-level AP diameter (midAP). All parameters were compared between groups. Discriminant functional analysis (DFA) was applied to detect CBCT parameters that best differentiate the NPD cyst from the normal canal.
Patients with NPD cyst had significantly greater values of APOO (7.06 ± 2.09 vs. 5.61 ± 1.70), MLOO (6.89 ± 2.95 vs. 3.48 ± 1.24), minML (2.88 ± 1.53 vs. 2.25 ± 1.09), AWE (2.15 ± 0.65 vs. 0.41 ± 0.67), and midAP (4.58 ± 1.61 vs. 2.48 ± 0.96). DFA showed MLOO, AWE, and midAP as the most accurate in distinguishing NPD cyst from the normal canal. When combined in the discriminant function equation X = 0.390·MLOO + 1.010·AWE + 0.288·midAP (cut score 1.669), the differentiation can be performed with a sensitivity and specificity of 98.8% and 76.9%, respectively.
NPD cysts can be accurately distinguished from the normal nasopalatine canal by measuring MLOO, AWE, and midAP diameter on CBCT images.
切牙孔宽度是诊断鼻腭管（NPD）囊肿的传统影像学标准。最近的 CBCT 研究表明，鼻腭管的尺寸有显著变化，这引发了对该标准准确性的质疑。本研究旨在探讨 CBCT 图像上测量的鼻腭管直径是否能准确地区分 NPD 囊肿与正常鼻腭管。
本研究纳入了 19 例 NPD 囊肿患者（男性 12 例，占 63.2%；女性 7 例，占 36.8%；平均年龄 44.7±13.3 岁）和 164 例对照组患者（男性 72 例，占 43.9%；女性 92 例，占 56.1%；平均年龄 47.25±17.74 岁）。对 CBCT 图像进行回顾性评估。在参考矢状位、冠状位和轴位重建图像上测量以下鼻腭管直径：鼻口前后径（AP）和内外径（ML）、口内口 AP（APOO）和内外径（MLOO）、鼻腭管长度、最小 ML 直径（minML）、前壁扩张（AWE）、鼻腭管角度和中平面 AP 直径（midAP）。比较两组间的所有参数。应用判别函数分析（DFA）检测最佳区分 NPD 囊肿与正常管的 CBCT 参数。
NPD 囊肿患者的 APOO（7.06±2.09 比 5.61±1.70）、MLOO（6.89±2.95 比 3.48±1.24）、minML（2.88±1.53 比 2.25±1.09）、AWE（2.15±0.65 比 0.41±0.67）和 midAP（4.58±1.61 比 2.48±0.96）值显著增大。DFA 显示 MLOO、AWE 和 midAP 是区分 NPD 囊肿与正常管的最准确参数。当结合到判别函数方程 X=0.390·MLOO+1.010·AWE+0.288·midAP（临界值 1.669）时，可分别实现 98.8%和 76.9%的敏感度和特异度。
通过 CBCT 图像测量 MLOO、AWE 和 midAP 直径可准确区分 NPD 囊肿与正常鼻腭管。
