锥形束CT与曲面断层在诊断下颌骨骨折中的比较研究

Comparative study of cone beam computed tomography and panoramic tomography in the diagnosis of the mandibular fractures

目的对比研究锥形束CT与曲面断层对下颌骨骨折的诊断特点及差异。方法收集2010年4月至2010年10月共27例因颌面部外伤行锥形束CT和曲面断层检查的患者的临床资料,比较两种方法对下颌骨不同部位骨折的诊断率。结果锥形束CT在下颌骨各部位的骨折诊断中均能明确观察骨折线及断端移位情况,而曲面断层存在漏诊现象,漏诊率为27.5%(11/40),特别是髁突及颏部骨折,漏诊率分别为35.3%和27.3%。结论曲面断层检查存在漏诊的可能,特别是髁突或颏部骨折时,漏诊率更高。建议对下颌骨骨折应结合锥形束CT检查,以避免漏诊。同时,锥形束CT三维重建在帮助医生制定手术计划方面有很大优势和广泛应用前景。

Objective To compare the usefullness of cone beam computed tomography（CBCT）and panoramic tomography in the diagnosis of mandibular fractures.Methods From April,2010 to October,2010,27 patients with maxillofacial trauma were subjected to both CBCT and panoramic tomography.The accuracy of diagnosis by the two examinations in different parts of mandibular fractures was observed and compared.Results All mandibular fractures were clearly observed by CBCT.Totally 11 mandibular fractures failed to be revealed on panoramic tomography.The rates of misdiagnosis of fractures in condylar and mental regions were 35.3% and 27.3%,respectively.Conclusion Panoramic tomography may misdiagnose the mandibular fractures,especially when the fractures take place in condylar or mental region.CBCT is more accurate in the diagnosis of mandibular fractures and helpful in making treatment plans for the doctors.