摘要
目的:对比分析下颌神经管在CBCT与曲面体层片上可见性的一致性,探讨影响下颌神经管在图像上可见性的非病变因素。方法:选取2013年12月~2014年2月期间在华西口腔医院同时拍摄了CBCT与曲面体层片的患者92例,由2位放射科医师同时观察患者的CBCT片与曲面体层片。把CBCT及曲面体层片上的下颌神经管从颏孔至下颌升支前缘处平分为1、2、3三个区域,分为0、1、2、3四个等级的分对下颌神经管的可见性进行评分。结果:2位医师间的内部一致性检验符合标准。CBCT上,区域1平均得分为2.120,区域2为2.337,区域3为2.533;曲面体层片上,区域1平均得分为1.772,区域2为1.973,区域3为2.207。越往后区域可见性越高。结论:CBCT对下颌神经管的可见性显著高于曲面体层片,仅有1%的下颌神经管在曲面体层片上可见,在CBCT上不可见。下颌神经管的可见性与年龄呈相关性,年龄越大,可见性越低。
Objective:To analyze the visualization consistency of mandibular canal on panoramic images and CBCT images,and to discuss the non-pathological factors influencing the visualization of mandibular canal.Methods:Using digital panoramic images and cone-beam computerized tomography images from 92 patients shooting in Hospital of Stomatology,Sichuan University during December 2013 to February 2014 and these images were evaluated by two radiologists.The mandibular canal was divided into 3equal width areas from mental foramen to anterior border of ramus.The visibility of the mandibular canal borders was assessed using 4point visibility scoring system,with lower scores for worse visibility.Results:The internal consistency inspection of two doctors conformed to the standard.In CBCT,average score of area 1was 2.120,area 2was 2.337,and area 3was 2.533.In panoramic average,score of area 1was 1.772,area 2was 1.973,and area 3was 2.207.Conclusion:CBCT remarkably improve the visualization of the mandibular canal in the area 1.The visualization of the mandibular canal in CBCT is significantly higher than in panoramic,while only 1% of the mandibular canal in panoramic is visible and is invisible in CBCT.There is a close correlation between age and visualization,and the visualization gets poor with age.
引文
[1] JoséVALLADARES-NETO,Lucia Helena CEVIDANES,Wesley Cabral ROCHA,et al.TMJ response to mandibular advancement surgery:an overview of risk factors[J].J Appl Oral Sci,2014,22(1)∶2-14
[2] Constantinus Politis,Xiomara Botero Ramirez,Yi Sun,et al.Visibility of mandibular canal on panoramic radiograph after bilateral sagittal split osteotomy(BSSO)[J].Surg Radiol Anat,2012,35(3)∶233-240
[3] Juan Muinelo-Lorenzo,Juan-Antonio Suarez-Quintanilla,Ana Fernandez-Alonso,et al.Anatomical characteristics and visibility of mental foramen and accessory mental foramen:Panoramic radiography vs.cone beam CT[J].Med Oral Patol Oral Cir Bucal,2015,20(6)∶e707-714
[4] Alexander Dudic,Catherine Giannopoulou,Michael Leuzinger,et al.Detection of apical root resorption after orthodontic treatment by using panoramic radiography and conebeam computed tomography of super-high resolution[J].Am J Orthod Dentofacial Orthop,2009,135(4)∶434-437
[5] Guilherme Mariano Fiuza Leite,Juliana Pelinsari Lana,Vinícius de Carvalho Machado,et al.Anatomic variations and lesions of the mandibular canal detected by cone beam computed tomography[J].Surg Radiol Anat.doi:10.1007/s00276-013-1247-5
[6] Munetaka Naitoh,Yuichiro Hiraiwa,Hidetoshi Aimiya,et al.Observation of Bifid Mandibular Canal Using ConeBeam Computerized Tomography[J].Int J Oral Maxillofac Implants,2009,24(1)∶155-159
[7] Christiano de Oliveira-Santos,Paulo Henrique Couto Souza,Soraya de Azambuja Berti-Couto,et al.Assessment of variations of the mandibular canal through cone beam computed tomography[J].Clin Oral Investig,2011,16(2)∶387-393
[8] Nahar Kamrun,Akemi Tetsumura,Yoshikazu Nomura,et al.Visualization of the superior and inferior borders of the mandibular canal:a comparative study using digital panoramic radiographs and cross-sectional computed tomography images[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2013,115∶550 557
[9] Ylikontiola L,Moberg K,Huumonen S,et al.Comparison of three radiographic methods used to locate the mandibular canal in the buccolingual direction before bilateral sagittal split osteotomy[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2002,93∶736-742
[10] Naitoh M,Katsumata A,Kubota Y,Hayashi M,et al.Relationship between cancellous bone density and mandibular canal depiction[J].Implant Dent,2009,18∶112-118
[11] M-S Kim,S-J Yoon,H-W Park,et al.A false presence of bifid mandibular canals in panoramic radiographs[J].Dentomaxillofacial Radiology,2011,40∶434-438