正畸患者上颌窦异常的锥形束CT和曲面体层检出率

Occurrence of maxillary sinus abnormalities detected by cone-beam CT and panoramic radiography in the patients receiving orthodontic treatment

目的应用锥形束CT(cone beam computed tomography,CBCT)和曲面体层片对正畸患者上颌窦异常的检出率进行研究。方法筛查2016年8月至2016年12月于北京大学口腔医学院·口腔医院正畸科就诊的患者影像资料,共纳入480例同日拍摄曲面体层片与CBCT患者的影像资料。分别测量和评估曲面体层片及CBCT图像中上颌窦异常情况,采用描述性统计分析、卡方检验、一致性检验等统计学方法对数据进行分析处理。结果曲面体层与CBCT对上颌窦异常的检出率有统计学差异(χ^2=346.32,P=0.000)。在纳入的480例、960侧上颌窦CBCT图像中,40.8%有上颌窦异常。其中,潴留性囊肿的检出率最高(18.2%),其次为黏膜增厚(15.1%)。男性与女性上颌窦异常检出率有统计学差异(χ^2=14.98,P=0.000)。青少年组与成年人组上颌窦异常检出率无统计学差异(χ^2=0.26,P=0.612)。结论对于上颌窦异常情况,CBCT检出率明显高于曲面体层片。在正畸人群中上颌窦异常较为常见,且以潴留性囊肿最为多见,患者的性别对上颌窦异常有影响,而年龄对上颌窦异常无影响。

ObjectiveThe objective of this study was to investigate maxillary sinus abnormalities in the patients who received orthodontic treatment by using cone-beam computed tomography (CBCT) and panoramic radiography.MethodsThe study sample comprised 480 consecutive patients who were candidates for orthodontic treatment and had taken CBCT and panoramic images at Peking University School and Hospital of Stomatology between August 2016 and December 2016. The 480 patients' radiographs were used for detection of abnormalities in maxillary sinuses. The sinus abnormalities include retention pseudocyst, thickened sinus mucosa and antrolith etc. Data were analyzed using descriptive statistics, chi-square tests and Kappa statistics.ResultsThe occurrence of maxillary sinus abnormalities detected in CBCT images was significantly higher than that in panoramic radiographs (χ2=346.32, P=0.000). Abnormalities were diagnosed in 40.8% of CBCT cases. Retention pseudocyst was the most detectable abnormality (18.2%), followed by thickened sinus mucosa (15.1%). There was a significant difference between genders (χ2=14.98, P=0.000). However, no significant difference could be found between the age groups (χ2=0.26, P=0.621). ConclusionsAbnormalities in maxillary sinus could be more accurately detected in CBCT images than in panoramic radiographs. Maxillary sinus abnormalities are common among patients who receive orthodontic treatment, and retention pseudocyst was the most detectable abnormality. The patients’ gender had an effect on the occurrence of maxillary sinus abnormalities, but age had no effect.