Sun L, Ma X, Zou Z
School of Stomatology, Beijing Medical University.
Zhonghua Kou Qiang Yi Xue Za Zhi. 1995 Mar;30(2):78-82, 127-8.
84 cadavers' temporomandibular joints were used to compare the results shown in standard lateral tomographs and Schuller's position films with gross views on the bone and cartilage changes. The results and conclusions were as follows: (1) The positive rates of the radiographic evidences were associated with the degrees of the macroscopic lesions. The more severe the macroscopic lesion, the higher the positive rate of radiographic evidence. (2) The sensitivity of radiographic examination was positively correlated with the extent of the macroscopic lesion. So, the negative predictive value was. However, the specificity and the positive predictive value of the radiographic examination were negatively correlated with macroscopic change index. It has been found that the more the extent of osteoarthrosis changes, the higher the sensitivity of radiographic examination; the higher the negative predictive values, the higher the positive rate of radiographic evidence, and the lower the underdiagnosis rate was. Meanwhile, the more the extent of bone pathological changes in the joint, the lower specificity of the radiographic examination, and the lower the positive predictive values and the misdiagnosis is increased. (3) The radiographic diagnostic value based on the standard latreal tomographs of TMJ, Schuller's position films or based on the both methods was not satisfied. Its underdiagnosis rate was higher. Therefore, we suggest that multiple-layers lateral tomography should be widely used in clinical practice.
使用84具尸体的颞下颌关节,将标准侧位断层片和许勒位片显示的结果与骨和软骨变化的大体观察结果进行比较。结果及结论如下:(1)影像学证据的阳性率与宏观病变程度相关。宏观病变越严重,影像学证据的阳性率越高。(2)影像学检查的敏感性与宏观病变范围呈正相关。因此,阴性预测值也是如此。然而,影像学检查的特异性和阳性预测值与宏观变化指数呈负相关。研究发现,骨关节炎变化程度越高,影像学检查的敏感性越高;阴性预测值越高,影像学证据的阳性率越高,漏诊率越低。同时,关节内骨病理变化程度越高,影像学检查的特异性越低,阳性预测值越低,误诊率增加。(3)基于颞下颌关节标准侧位断层片、许勒位片或两种方法的影像学诊断价值均不理想。其漏诊率较高。因此,我们建议多层侧位断层扫描应在临床实践中广泛应用。