颌骨牙源性囊性病变诊断中X线数字化断层融合成像与MSCT的应用价值

Study the Diagnostic Value of X-ray Digital Tomosynthesis and MSCT in the Diagnosis of Odontogenic Cystic Lesions of the Jaw

目的:探讨X线数字断层融合成像与MSCT(多层螺旋CT)在颌骨牙源性囊性病变中的诊断意义。方法:研究对象为2015年9月12日至2017年8月20日55例颌骨牙源性囊性病变患者。所有患者均分别实施X线数字化断层融合成像(观察组)、MSCT(对照组),金标准取病理检查结果。观察两组诊断符合情况、软组织受损、根尖情况。结果:在诊断符合情况方面,观察组伪影干扰下数据为87.50%,高于对照组,无伪影干扰下数据为74.36%,低于对照组,P<0.05;观察组软组织受损诊断准确度为69.09%,较对照组显然更低,P<0.05;根尖病变以削尖、变钝、截断及残缺不全等为主,在层厚为3mm时,观察组根尖显示概率为89.09%,较对照组更高,P<0.05,两组其他数据不具高度对比价值,P>0.05。结论:颌骨牙源性囊性病变中,无伪影干扰下,相比X线数字化断层融合,MSCT软组织显示等情况更佳,准确性更高,针对存在重叠干扰者,予以X线数字化断层融合优势明显,可避开假牙等干扰,确保诊断准确性,具有操作方便、低辐射、直观等优势,值得进一步推广。

Objective： To investigate the diagnostic value of X-ray digital tomography and MSCT in the diagnosis of odontogenic cystic lesions of the jaw. Methods： 55 cases of odontogenic cystic lesions were selected in our hospital from September 12 th 2015 to August 20 th 2017. All patients underwent X-ray digital tomography and MSCT respectively. The ones who given X-ray computed tomography as the observation group and the one given MSCT as the control group. The gold standard was taken as the pathological examination result, then observed and compared the diagnosis, soft tissue damage, apical conditions of two groups of two groups. Results： In the diagnosis of compliance, the observation group artifact interference rate was 87.50%, which higher than the control group; and no artifacts interference rate was 74.36%, which lower than the control group, P0.05; The diagnostic accuracy of soft tissue damage in the observation group was 69.09%, which was significantly lower than that in the control group（P0.05）. The main symptoms of apical lesions were sharpening, dullness, truncation and incomplete deformity. When the layer thickness was 3 mm, the probability of apical display in observation group was 89.09%, which was higher than that in control group（P0.05）. The other two sets of data do not have high contrast value, P0.05. Conclusion： In the case of odontogenic cystic lesions of the jaws, the MSCT soft tissue showed better and more accuracy than X-ray digital tomography without artifact interference. For patients with overlapping interference, the X-ray digital tomography fusion has obvious advantages, which could avoid the interference of dentures and ensure the accuracy of diagnosis. It has the advantages of easy operation, low radiation and visualization. It was worth to be further popularized.