Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis
Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis
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DOI：
10.1016/j.tripleo.2009.02.023
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发表时间：
2009-06-01
期刊：
影响因子：
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通讯作者：
Schiffman, Eric L.
中科院分区：
文献类型：
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作者：
Ahmad, Mansur;Hollender, Lars;Schiffman, Eric L.
Objective.作为颞下颌关节紊乱病多中心研究诊断标准（RDC/TMD）验证项目的一部分，开发了全面的颞下颌关节诊断标准，用于使用全景X线摄影、磁共振成像（MRI）和计算机断层扫描（CT）进行图像分析。使用kappa（kappa）统计量估计检查者间可靠性，评价者对之间的一致性以总体、阳性和阴性一致性百分比为特征。计算机断层扫描是评估其他影像学检查方法检测骨关节炎（OA）有效性的参考标准。对于OA的放射学诊断，3名检查者的可靠性在全景X线摄影中较差（kappa = 0.16），在MRI中一般（kappa = 0.46），在CT中接近极好的阈值（kappa = 0.71）。使用MRI，诊断椎间盘移位（DD）伴复位（kappa = 0.78）和DD不伴复位（kappa = 0.94）的可靠性极佳，积液的可靠性良好（kappa = 0.64）。对于所有条件，成对评级的总体一致性百分比>= 82%。诊断OA的阳性百分比一致率为19%的全景X线摄影，59%的MRI和84%的CT。使用MRI，诊断任何DD的阳性百分比一致率为95%，积液为81%。所有条件下的阴性一致率均>= 88%。与CT相比，曲面断层摄影和MRI诊断OA的敏感性较差，但特异性较好。为RDC/TMD确认项目制定了全面的图像分析标准，该标准可可靠地用于使用CT评估OA以及使用MRI评估椎间盘位置和积液。(Oral《口腔外科医学》、《口腔病理学》、《口腔放射学》、《口腔内分泌学》2009年; 107：844-860）
Objective. As part of the Multisite Research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) Validation Project, comprehensive temporomandibular joint diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computerized tomography (CT).Study design. Interexaminer reliability was estimated using the kappa (kappa) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. Computerized tomography was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA).Results. For the radiologic diagnosis of OA, reliability of the 3 examiners was poor for panoramic radiography (kappa = 0.16), fair for MRI (kappa = 0.46), and close to the threshold for excellent for CT (kappa = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (kappa = 0.78) and for DD without reduction (kappa = 0.94) and good for effusion (kappa = 0.64). Overall percent agreement for pairwise ratings was >= 82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and of effusion was 81%. Negative percent agreement was >= 88% for all conditions. Compared with CT, panoramic radiography and MRI had poor and marginal sensitivity, respectively, but excellent specificity in detecting OA.Conclusion. Comprehensive image analysis criteria for the RDC/TMD Validation Project were developed, which can reliably be used for assessing OA using CT and for disc position and effusion using MRI. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 844-860)