| 摘要: |
| 目的 比较X线片、超声、CT、锥形束CT（CBCT）对不同位置下颌下腺结石的检出率，探讨三维可视化技术在下颌下腺结石诊疗中的辅助价值。方法 回顾性分析2014年11月至2021年3月宁夏医科大学总医院113例下颌下腺结石患者的X线片、超声、CT、CBCT检查资料，比较4种成像方法对不同位置结石的检出率及总检出率。利用Mimics 19.0软件和CBCT数据对结石进行3D重建，从可视化角度观察结石的位置、大小、形态及数目。结果 CBCT和CT对下颌下腺结石的总检出率差异无统计学意义［98.2%（111/113） vs 95.6%（108/113），P＞0.05］，但均高于X线片（65.5%，74/113）和超声（73.5%，83/113）的总检出率。超声对导管前、中段结石的检出率最低［分别为63.6%（21/33）、72.2%（26/36）］，与CBCT［分别为97.0%（32/33）、100.0%（36/36）］、CT［分别为93.9%（31/33）、97.2%（35/36）］相比差异均有统计学意义（均P＜0.05）。X线片对导管后段结石的检出率低于超声、CBCT、CT［40.9%（18/44） vs 81.8%（36/44）、97.7%（43/44）、95.5%（42/44），均P＜0.01］。将CBCT数据导入Mimics 19.0软件后，成功地对不同大小、形态及数目的下颌下腺结石进行了可视化重建，重建图像清晰，结石与下颌骨的解剖位置关系显示直观。结论 CBCT对下颌下腺结石的诊断具有良好的应用价值，可替代传统CT进行涎石病诊断。对于双手双合诊未查及但超声提示的导管后段结石，可直接行CBCT检查进行精确诊断；对于导管前、中段结石，可考虑X线片和CBCT检查。可视化技术有助于临床患者宣教及制定个体化治疗方案。 |
| 关键词: 下颌下腺结石 锥形束计算机断层扫描 诊断 数据可视化 |
| DOI：10.16781/j.CN31-2187/R.20230464 |
| 投稿时间：2023-08-15修订日期：2024-01-18 |
| 基金项目:国家自然科学基金（81860203）． |
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| Application value of cone beam CT in accurate diagnosis of submandibular gland calculi |
| YANG Xiaofeng,SUN Xiaojuan,QIAO Guangwei*,ZHOU Zhongwei,LAN Huixia |
(Department of Oral Medicine, Hospital of Stomatology, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
* Corresponding author) |
| Abstract: |
| Objective To compare the detection rates of X-ray, ultrasound, computed tomography (CT) and cone beam CT (CBCT) for submandibular gland calculi in different positions, and to explore the auxiliary value of 3-dimensional visualization technology in diagnosis and treatment of submandibular gland calculi. Methods The X-ray, ultrasound, CT and CBCT examination data of 113 patients with submandibular gland calculi at General Hospital of Ningxia Medical University from Nov. 2014 to Mar. 2021 were retrospectively analyzed. The detection rates and overall detection rates of the 4 imaging methods for calculi in different positions were compared. Mimics 19.0 software and CBCT data were used for 3D reconstruction imaging, visually displaying the location, size, morphology, and number of calculi from a visual perspective. Results There was no significant difference in the total detection rate of submandibular gland calculi between CBCT and CT (98.2% ［111/113］ vs 95.6% ［108/113］, P＞0.05), but both were significantly higher than that of X-ray (65.5%, 74/113) and ultrasound (73.5%, 83/113). The detection rates of ultrasound for calculi in the anterior and middle ducts were the lowest (63.6% ［21/33］ and 72.2% ［26/36］, respectively), which were significantly different from those of CBCT (97.0% ［32/33］ and 100.0% ［36/36］, respectively) and CT (93.9% ［31/33］ and 97.2% ［35/36］, respectively) (all P＜0.05). The detection rate of X-ray for calculi in the posterior duct was significantly lower than that of ultrasound, CBCT, and CT (40.9% ［18/44］ vs 81.8% ［36/44］, 97.7% ［43/44］, and 95.5% ［42/44］, all P＜0.01). After CBCT data were imported into Mimics 19.0 software, submandibular gland calculi with different sizes, shapes, or numbers were successfully visualized and reconstructed. The reconstructed image was clear, and anatomical position relationship between the calculi and the mandible was visualized. Conclusion CBCT has good application value in the diagnosis of submandibular gland calculi and can replace traditional CT for the diagnosis of sialolithiasis. Clinically, CBCT examination can be directly performed for accurate diagnosis of calculi in the posterior duct which are not detected by double coincidence diagnosis but are indicated by ultrasound. For calculi in the anterior and middle ducts, X-ray and CBCT are preferred. Visualization technology helps clinical patient education and the development of personalized preoperative treatment plans. |
| Key words: submandibular gland calculi cone beam computed tomography diagnosis data visualization |
