曲面断层片和头颅后前位片诊断下颌骨不对称的可行性探讨  

Validity of panoramic radiographs and posteroanterior cephalometry for measuring mandibular asymmetry

作　　者：黄颖荷 钟小龙[2] 刘克谨[3] 彭伟[2] 周月虹[2] 

机构地区：[1]台山市人民医院口腔科,广东台山529200 [2]中山大学附属第一医院口腔科,广东广州510080 [3]广东省口腔医院.南方医科大学附属口腔医院,广东广州510280

出　　处：《临床口腔医学杂志》2012年第2期97-100,共4页Journal of Clinical Stomatology

基　　金：广东省卫生厅科研项目(A2011689)

摘　　要：目的:探讨曲面断层片和头颅后前位片在分析下颌不对称畸形中的作用。方法:人头颅骨标本5具,常规方法分别拍摄有钢珠标志和无钢珠标志的头颅标本的X线后前位定位片(PAC)和曲面断层片(Pa)。选取25例下颌不对称畸形患者的PAC和Pa。分别测量颅骨标本实体、颅骨标本的PAC和Pa、以及患者的PAC和Pa中的髁突长、下颌升支长和下颌体长。对颅骨标本测量项目的实际值和相应的影像测量值进行相关性检验,比较25例患者PAC和Pa的相应测量值的差异指数,用图表观察不同测量者测量同一样本所得测量结果的离散度。结果:当颅骨标本有钢珠标志时,其大部分影像测量值与实际值显示很强的相关性(0.96～0.99,P<0.01)。当颅骨标本无钢珠标志时,Pa测量的髁突长和下颌升支长与实际值有很强的相关性,PAC所测下颌升支长和下颌体长与实际值的相关性降低,髁突长无法测量。不同测量者测量下颌升支长时,在Pa所测的可重复性要比在PAC所测者高,测量下颌体长时,在PAC所测的可重复性则比在Pa高。结论:PAC对评价下颌骨水平向不对称较有价值,对评价下颌骨垂直向不对称的作用有限;Pa对评价下颌骨水平向不对称的价值不高,但对评价下颌骨垂直向不对称有确切的意义。Objective:To evaluate the reliability and validity of the panoramic radiographs and posteroanterior cephalometry for diagnosing asymmetry of the mandibular asymmetry.Method:Conventional posteroanterior cephalometry(PAC) and panoramic(Pa) were taken from five skulls witch were marked and not marked with steel ball bearings.PAC and Pa were selected from 25 cases with mandibular asymmetry.The condylar height,the total ramal height and the mandibular body length were measured on skulls,PAC and Pa of the skulls,and PAC and Pa of the patients.Their dates were analyzed.Result:When the anatomic structures of the skulls were marked,most correlation coefficients demonstrated high correlation between the measurements on the skulls and their radiographs which were more than 0.96.When the anatomic structures of the skulls were not marked,the correlation coefficients between the measurements on the skulls and the radiographs for the condylar height and the total ramal height from Pa also demonstrated high correlation,but reduced for the total ramal height and the mandibular body length from PAC.The repeatability of measurement results was better on Pa when the total ramal height was measured by different persons,whereas was better on PAC when the mandibular body length was measured.Conclusion:This study suggests that the posteroanterior cephalometry can be used to evaluate horizontal mandibular asymmetry,whereas the panoramic radiograph can be used to evaluate vertical mandibular asymmetry.

关 键 词：曲面断层片 头颅后前位片 不对称畸形 

分 类 号：R816.98[医药卫生—放射医学]