邻面龋翼片计算机自动分析诊断系统的建立和评价

Establishment and evaluation of a computer-based software system for detection of initial approximal caries

目的提高早期邻面龋的临床诊断水平,建立邻面龋X线图像的计算机自动分析诊断系统(CDS),并对诊断效果进行初步评价。方法对含有早期邻面龋损、模拟天然牙列的95颗离体牙,进行平行投照的翼片检查并获得X线图像。通过对邻面龋损特征的分析比较,运用Matlab和VC语言,建立CDS。应用该系统自动检测牙齿邻面是否存在龋损及其深度。同时由8位检查者阅片。以组织学结果为金标准,评价诊断的准确度、敏感度、特异度及一致性等水平。结果CDS诊断的敏感度为0·728,阅片法的平均敏感度为0·543。系统诊断深度与组织学深度的Pearson相关系数为0·722,优于肉眼阅片与组织学深度的相关系数(0·584)。系统重复检测的一致性较好。结论CDS可以对邻面早期龋损进行自动诊断,其总体诊断水平优于肉眼阅片。

Objective To establish and evaluate a computer-based software system （caries diagnosing system,CDS）：CDS for better detection of initial approximal caries based on the performance of radiography. Methods A total of 190 approximal surfaces from 95 extracted posterior teeth were examined by bite-wing radiography. After analysing and extracting the approximal lesion＇s characteristics of X-ray performance, using Matlab and VC language , the CDS was established. Then the proximal surfaces of these teeth were detected automatically by CDS , and scored by naked eyes of 8 experienced dentists for the extent of lesions. The histological appearance of sectioned teeth was used as the gold standard to assess sensitivity, specificity, accuracy, and reproducibility. Results The sensitivity of CDS was 0. 728, Pearson＇s correlation was 0. 722,better than that of optic estimation. The reproducibility of CDS was good too. Condusions The CDS can report the lesion site and extension, its diagnostic level is better than that of optic estimation, it is an reasonably sensitive and accurate method for the detection of initial approximal caries in present clinic practice, and a tool of providing objective data.