根尖平行投照X线摄影与不同视野（FOV）的锥形束计算机断层扫描（CBCT）在根尖周病变检测中的比较。
Comparison of periapical parallel radiography with cbct with different field of views (FOV) for the detection of periapical lesions.
作者信息
Sheikhi Mahnaz, Abdinian Mehrdad, Roshanzamir Najmeh, Aghaziarati Fatemeh
机构信息
Department of Oral and Maxillofacial Radiology, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Dent Res J (Isfahan). 2024 Dec 20;21:67. doi: 10.4103/drj.drj_466_23. eCollection 2024.
BACKGROUND
Chronic apical periodontitis (AP) may influence the outcome of root canal treatment. Thus, it is important to diagnose AP using the best method available. This research was done to compare the diagnostic accuracy of parallel periapical radiography (PR) and different field of views (FOVs) of cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
This study was done on six human mandibles. After extraction of the teeth, periapical lesions with different sizes were prepared randomly by drilling a hole at the base of the socket using a bur. From among 67 sockets, 21 sockets had no lesion (control); then, all mandibles were scanned by CBCT with different FOVs and paralleling periapical technique radiography. The images were assessed by two examiners. The quantitative data were analyzed by intraclass correlation coefficient (ICC) and the qualitative data were analyzed by McNemar's test (α = 0.05). Sensitivity, specificity, and accuracy were calculated. Inter-observer agreement was assessed using kappa statistics for qualitative data and ICC for quantitative data.
RESULTS
The quantitative scores were compared with the gold standard using ICC, which showed maximum agreement for the dental FOV of CBCT (93.3) and minimum agreement for PR (62.5) ( < 0.001). For qualitative data, maximum agreement was found for the dental FOV of CBCT (97.1%), and minimum agreement was reported for PR (59.7%). Kappa values were variable between 0.271 and 0.924 ( < 0.001). Maximum sensitivity was found for the dental FOV of CBCT (96%) and minimum sensitivity was observed for PR (51%). The inter-observer agreement was 0.922 for qualitative data and 0.90 for quantitative data ( < 0.001). There were no significant differences between CBCT with different FOVs and defect sizes (gold standard) while we found significant differences for periapical by defect sizes.
CONCLUSION
CBCT with dental FOV presents the highest sensitivity and diagnostic accuracy for detection and characterization of simulated AP.
背景
慢性根尖周炎（AP）可能会影响根管治疗的效果。因此，采用现有最佳方法诊断AP很重要。本研究旨在比较平行根尖片（PR）和锥束计算机断层扫描（CBCT）不同视野（FOV）的诊断准确性。
材料与方法
本研究对六具人类下颌骨进行。拔牙后，使用牙钻在牙槽窝底部随机钻出不同大小的根尖周病变。在67个牙槽窝中，21个牙槽窝无病变（对照组）；然后，对所有下颌骨进行不同视野的CBCT扫描和平行根尖片技术摄影。图像由两名检查者评估。定量数据采用组内相关系数（ICC）分析，定性数据采用McNemar检验（α = 0.05）分析。计算敏感性、特异性和准确性。使用kappa统计量评估定性数据的观察者间一致性，使用ICC评估定量数据的观察者间一致性。
结果
使用ICC将定量评分与金标准进行比较，结果显示CBCT的牙科视野一致性最高（93.3），PR的一致性最低（62.5）（P < 0.001）。对于定性数据，CBCT的牙科视野一致性最高（97.1%），PR的一致性最低（59.7%）。Kappa值在0.271至0.924之间变化（P < 0.001）。CBCT的牙科视野敏感性最高（96%），PR的敏感性最低（51%）。定性数据的观察者间一致性为0.922，定量数据的观察者间一致性为0.90（P < 0.001）。不同视野的CBCT与缺损大小（金标准）之间无显著差异，而我们发现根尖片在缺损大小方面存在显著差异。
结论
具有牙科视野的CBCT在检测和表征模拟AP方面具有最高的敏感性和诊断准确性。
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