X线数字化断层融合成像与MSCT在颌骨牙源性囊性病变诊断中的评估对比

摘要

目的：评估X线数字化断层融合（TOMOS）成像在口腔有固定金属假牙颌骨牙源性囊性病变诊断中的应用价值，并与多层螺旋CT（MSCT）进行对比。方法：回顾性分析40例经病理证实的口腔有固定金属假牙颌骨牙源性囊性病变的影像资料，所有病例均行MSCT及TOMOS扫描，其中13例增强。将两种检查方法的影像表现特征进行分类比较，评估其显示病灶及毗邻结构的优劣和诊断价值。结果：两种方法在评价病变的结构特点、病变与皮质及周围器官关系比较差异无显著性（一致性检验Kappa值＞0．4），显示根尖改变TOMOS优于MSCT，有伪影干扰时，对纯囊性及囊实性灶的诊断准确率，TOMOS优于MSCT，但显示软组织受侵犯不如MSCT。结论： TOMOS与MSCT在显示颌骨牙源性囊性病变影像特点作用相当，值得推广，当病灶有金属伪影干扰时，应选择TOMOS。%Objective To evaluate the value of digital tomosynthesis (TOMOS)in diagnosis of odontogenic cystic lesions of the jaws with oral fixed metal dentures, and compared with multi-slice spiral CT (MSCT). Methods The imaging findings of 40 cases with fixed metal dentures pathologically proved odontogenic cystic lesions of the jaws jn retrospective were retrospectively analyzed.All cases were performed by MSCT and TOMOS scanning,and 13 cases enhanced at the same time. The characteristics of the imaging findings in TOMOS and MSCT were compared. The diagnosis merits and disadvantages, especially their ability to detect the lesions and adjacent structures,were assessed. Results There were no significant difference (consistency check Kappa value>0.4) in evaluating the structure characteristics of the lesions, the relationgship between the lesions and cortex ,and the relationship between the lesions and surrounding organs. TOMOS is superior to MSCT in displaying apical change, the same in pure cystic and cystic-solid lesions interfered by artifacts.However, it is inferior to MSCT in detection of soft tissue invasion. Conclusion There is similar assessment value of TOMOS and MSCT in displaying odontogenic cystic lesions of the jaws. TOMOS can be chosen when the imaging findings of the lesions are interfered by metal artifacts.