A Mathematical Approach to Diagnosis of Oral Lesions - Diagnosis of Radiographic Images -

口腔病变的准确诊断需要综合临床体征、症状、既往病史及影像学、组织病理学等各项检查结果等大量信息。医生需要多年的临床经验，才能从大量的信息中进行选择，并只利用有用的信息。但是，如果积累的信息能够以一种更易于利用和获取的形式进行分类，并且能够在有关病例中快速引用，则在一定程度上可以减少医生个人经验的差异，并提高诊断的准确性。我们输入患者的年龄、性别、病变部位、疾病、影像数据作为基础数据，并根据这些数据计算计算机辅助医疗决策中正确诊断的概率。1987 ~ 1992年6年间，在大阪牙科大学口腔放射科对10126例患者进行了检查，其中9376例患者的资料被分类作为基础资料。建立了炎症、牙源性囊肿、非牙源性囊肿、牙源性肿瘤、非牙源性肿瘤、恶性肿瘤、创伤、颞下颌关节紊乱、不可分类疾病等10个疾病类别（68个病变）。病变部位分为上颌窦、上颌骨、下颌骨、颞下颌关节、唾液腺、软组织等7类（32个部位）。x线影像分为正常、颌骨放射透光、颌骨放射不透明、颌骨部分放射透光和部分放射不透明、骨骼异常、颞下颌关节紊乱、唾液腺病变等7种（18种模式）。在64%的患者中，最常见的x线表现是颌骨透光，86%的患者出现了炎症。在14%的患者中，颌骨没有变化，这是第二常见的x线表现。我们从这些数据中得出骨内病变的症状-疾病矩阵，并计算后验概率。这种后验概率被认为有助于解释x射线图像，以进行医疗决策。少

Accurate diagnosis of oral lesions can be made only by corn-prehensive evaluation of a large quantity of information including in clinical signs and symptoms, and the past history as well as findings on various examinations including Radiographical and histopathological examinations. Clinical experience over many years is needed for a physician to become able to select from a large volume of information and utilize only that which is useful. However, if the accumulated information can be classified in a more utilizable and accessible form and can be quickly referred to concerning the case in question, it would, to some extent, diminish the difference in experience among individual doctors and improve the accuracy of the diagnosis.We input the age, sex, site of the lesion, disease, and image data of patients as basic data, and calculated the probability of the correct diagnosis in computer-aided medical decision making based on these data. Data of 9,376 of the 10,126 patients who were e … More xamined at the Department of Oral Radiology, Osaka Dental University during the 6 years between 1987 and 1992 was classified and used as basic data.Ten disease categories (68 lesions), i.e., inflammation, odontogenic cysts, non-odontogenic cysts, odontogenic tumors, non-odontogenic tumors, malignant tumors, trauma, TMJ disorders, unclassifiable diseases, and others were established. The sites of the lesions were classified into 7 categories (32 sites), i.e., the maxillary sinus, maxillary bones, mandibular bones, temporo-mandibular joint, salivary glands, soft tissues, and others. Radiographic images were classified into 7 types (18 patterns), i.e., normal, radiolucencies of the jaws, radiopacities of the jaws, partly radiolucencies and partly radiopacities of the Jaws, anomaly of skeletal bones, TMJ disorders, lesions of salivary glands, and others. Radiographical findings were most frequently radiolucencies of the jaws, which were observed in 64% of the patients, and inflammation accounted for 86% No changes, which were the next most frequent X-ray findings, were observed in the jaw bones in 14%. We derived a symptom-disease matrix of intra-osseous lesions from these data and calculated the posterior probability.This posterior probability is considered to assist interpretation of X-ray images for medical decision making. Less