A comparative study of cone-beam CT and multidetector CT in the preoperative assessment of odontogenic cysts and tumors

摘要

Aim of the work To compare the accuracy of cone beam CT (CBCT) and multidetector CT (MDCT) in the preoperative radiological assessment of odontogenic cysts and tumors. Material and methods This prospective study included 24 patients (13 males and 11 females) with primary untreated pathologically proven odontogenic cysts and tumors. Their ages ranged from 5–45 years. They underwent (CBCT) and (MDCT). All CBCT and MDCT images were reviewed for morphologic characteristics of the lesions, internal appearance, extension as well as effect on surrounding structures. All patients were scheduled for surgical treatment within one week after clinical and radiological evaluation. Using intra-operative findings as the gold standard, the accuracy of (CBCT) and (MDCT) for radiological assessment of odontogenic cyst and tumors was compared. Results Histopathologic examination established that of the 24 tumors; 10 were radicular cyst, five dentigerous cyst, three amelobalstoma, three odontogenic keratocyst, one buccal bifurcation cyst, one nasopalatine cyst, and one lateral periodontal cyst. Both CBCT and MDCT were identical in detecting location, borders and internal structure of examined lesions. Concerning linear measurements of the lesions, MDCT underestimated mean depth by 1.7 mm and CBCT underestimated it by 0.9 mm. MDCT underestimated the mean width by 0.9 mm, and CBCT underestimated it by 0.7 mm. MDCT overestimated the mean height by 1.7 mm and CBCT overestimated it by 1 mm. CBCT was superior than MDCT in detecting thinning and perforation of buccal cortical plate and displacement of teeth. Conclusion In the overall assessment of odontogenic cysts and tumors, CBCT was comparable with MDCT with no significant statistical difference ( P 0.05). However, CBCT was more accurate in linear measurements and identification of tooth displacement and buccal bone defect. It is an optimal radiological modality for preoperative radiological assessment of odontogenic tumors.