Lateral cephalometric analysis for treatment planning in orthodontics based on MRI compared with radiographs: A feasibility study in children and adolescents
Lateral cephalometric analysis for treatment planning in orthodontics based on MRI compared with radiographs: A feasibility study in children and adolescents
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DOI：
10.1371/journal.pone.0174524
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发表时间：
2017-03-23
期刊：
影响因子：
3.7
通讯作者：
Zingler, Sebastian
中科院分区：
文献类型：
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作者：
Heil, Alexander;Gonzalez, Eduardo Lazo;Zingler, Sebastian
本前瞻性研究的目的是评估磁共振成像（MRI）是否相当于侧位X线头影测量（LCR，“金标准”）在cephalometric analysis.MethodsThe应用MRI技术进行了优化，扫描时间短，高分辨率，高对比度和几何精度。在正畸治疗之前，20名患者（平均年龄+/-SD，13.95岁+/-5.34）接受了MRI和LCR。将MRI数据集后处理为侧位头颅X线片。由两名独立观察员对两种模式进行两次头影测量分析，间隔4周。确定了8个双侧和10个正中矢状标志，并计算了24个广泛使用的测量值（14个角度，10个距离）。通过使用组内相关系数（ICC），Bland-Altman分析和两个单侧检验（TOST）在预定义的等效范围内的+/-2度/mm.ResultsMRI技术的几何精度进行统计分析，证实了幻影测量。MRI和LCR的平均观察者内ICC分别为0.977/0.975和0.975/0.961。MRI和LCR的平均观察者间ICC分别为0.980和0.929。Bland-Altman分析显示两种模式之间的一致性水平较高，距离的偏倚范围（平均值+/-SD）为-0.66至0.61 mm（0.06 +/-0.44），角度的偏倚范围为-1.33至1.14度（0.06 +/-0.71）。除切间角（p = 0.17）外，所有测量值在统计学上均相等（p <0.05）。结论本研究证明了基于MRI的无辐射照射的正畸治疗计划的可行性。高分辨率各向同性MRI数据集可以转换为侧位头颅定位片，从而在正畸常规中应用可靠的测量结果，与LCR上的相应测量结果高度一致。
ObjectiveThe objective of this prospective study was to evaluate whether magnetic resonance imaging (MRI) is equivalent to lateral cephalometric radiographs (LCR, "gold standard") in cephalometric analysis.MethodsThe applied MRI technique was optimized for short scanning time, high resolution, high contrast and geometric accuracy. Prior to orthodontic treatment, 20 patients (mean age +/- SD, 13.95 years +/- 5.34) received MRI and LCR. MRI datasets were postprocessed into lateral cephalograms. Cephalometric analysis was performed twice by two independent observers for both modalities with an interval of 4 weeks. Eight bilateral and 10 midsagittal landmarks were identified, and 24 widely used measurements (14 angles, 10 distances) were calculated. Statistical analysis was performed by using intraclass correlation coefficient (ICC), Bland-Altman analysis and two one-sided tests (TOST) within the predefined equivalence margin of +/- 2 degrees/mm.ResultsGeometric accuracy of the MRI technique was confirmed by phantom measurements. Mean intraobserver ICC were 0.977/0.975 for MRI and 0.975/0.961 for LCR. Average interobserver ICC were 0.980 for MRI and 0.929 for LCR. Bland-Altman analysis showed high levels of agreement between the two modalities, bias range (mean +/- SD) was -0.66 to 0.61 mm (0.06 +/- 0.44) for distances and -1.33 to 1.14 degrees (0.06 +/- 0.71) for angles. Except for the interincisal angle (p = 0.17) all measurements were statistically equivalent (p < 0.05).ConclusionsThis study demonstrates feasibility of orthodontic treatment planning without radiation exposure based on MRI. High-resolution isotropic MRI datasets can be transformed into lateral cephalograms allowing reliable measurements as applied in orthodontic routine with high concordance to the corresponding measurements on LCR.