5T MRI对青年人群牙髓及牙周膜的体内成像效果研究OA
Study on the in vivo effects of 5T magnetic resonance imaging on the dental pulp and periodontal ligament in young adults
目的 探讨5T磁共振成像(5T magnetic resonance imaging,5T MRI)对青年人群牙髓及牙周膜组织的体内成像效果,为高场核磁共振技术在口腔临床检查中的应用提供依据.方法 获得单位医学伦理委员会审批,共招募15名健康志愿者(纳入413颗恒牙),进行全口腔5T MRI扫描,其中6名志愿者(纳入共168颗恒牙)同时接受3T磁共振成像(3T magnetic resonance imaging,3T MRI)和锥形束CT(cone-beam computed tomog-raphy,CBCT)扫描.由两名口腔科医师采用5级Likert量表对图像上的牙髓及牙周膜成像效果进行独立评分,并记录每颗牙可检测到的根管数目.采用加权kappa检验法和组内相关系数(intraclass correlation coeffi-cient,ICC)评估评分者间一致性.通过非参数检验比较不同组织结构、牙位及成像方式间的成像效果差异.结果 5T MRI能对大部分牙髓组织和部分牙周膜结构实现体内成像;两名评分者对牙髓及牙周膜成像评分的一致性较高(牙髓κ=0.934,牙周膜κ=0.737);牙髓的成像评分显著高于牙周膜(P<0.001),且磨牙牙髓的评分低于前磨牙和前牙.在6名志愿者的多模态对比中,评分者对5T MRI、3T MRI、CBCT成像方式的牙髓、牙周膜评分及根管计数均具有良好一致性(5T MRI牙髓κ=0.971,3T MRI牙髓κ=0.933,CBCT牙髓κ=0.964;5T MRI牙周膜κ=0.625,3T MRI牙周膜κ=0.667,CBCT牙周膜κ=0.571;根管计数ICC均≥0.990).5T MRI对牙髓和牙周膜的成像评分明显高于3T MRI(牙髓:P<0.001;牙周膜:P=0.022),但两者在根管数目的检出率方面差异无统计学意义(P>0.05).虽然5T MRI对牙髓、牙周膜的成像评分以及根管数目的检出率方面不如CBCT(牙髓成像评分:P<0.001;牙周膜成像评分:P=0.02;根管数目:P<0.05),但却能在真正意义上对这两种软组织实现"直接成像".结论 5T MRI能对青年人群的牙髓及牙周膜组织实现较好的体内直接成像效果,提示其在牙髓及牙周相关疾病的临床诊疗中具有潜在应用价值.
Objective To evaluate the performance of 5T magnetic resonance imaging(MRI)in visualizing dental pulp and periodontal ligament(PDL)tissues in vivo in the young adult population,thereby providing a basis for the ap-plication of high-field MRI technology in clinical oral examinations.Methods The study was approved by the Ethics Committee of the hospital.A total of 15 healthy volunteers(413 permanent teeth altogether)were recruited and under-went full-mouth 5T MRI scans.Among them,six volunteers(168 permanent teeth)also received both 3T MRI and cone-beam computed tomography(CBCT)scans.Two dental specialists independently evaluated the imaging quality of the dental pulp and PDL on the images using a 5-point Likert scale and recorded the number of detectable root canals for each tooth.Inter-rater agreement was assessed using weighted kappa statistics and intraclass correlation coefficient(ICC).Non-parametric tests were employed to compare differences in imaging performance among different tissue struc-tures,tooth positions,and imaging modalities.Results 5T MRI can achieve in vivo imaging for most dental pulp tis-sues and partial periodontal membrane structures.There was a high level of agreement between the two raters in their imaging scores for the dental pulp and PDL(dental pulp κ=0.934,PDL κ=0.737).The imaging scores for dental pulp were significantly higher than those for PDL(P<0.001),and the scores for molar dental pulp were lower than those for premolars and anterior teeth.In the multimodal comparison involving six volunteers,the raters showed good consistency in scoring dental pulp and PDL imaging across 5T MRI,3T MRI,and CBCT,as well as in root canal counts(5T MRI for dental pulp κ=0.971,3T MRI for dental pulp κ=0.933,CBCT for dental pulp κ=0.964;5T MRI for PDL κ=0.625,3T MRI for PDL κ=0.667,CBCT for PDL κ=0.571;ICC for root canal counts all≥0.990).The imaging scores for dental pulp and PDL using 5T MRI were significantly higher than those using 3T MRI(dental pulp:P<0.001;PDL:P=0.022),but there was no statistically significant difference in the detection rate of the number of root canals between the two(P>0.05).Although the imaging scores for dental pulp and PDL as well as the detection rate of the number of root canals with 5T MRI were inferior to those with CBCT(dental pulp:P<0.001;PDL:P=0.02;number of root canals:P<0.05),5T MRI can truly achieve"direct imaging"of these two soft tissues.Conclusion 5T MRI en-ables effective in vivo direct imaging of dental pulp and PDL tissues in the young adult population,indicating its poten-tial clinical application value in the diagnosis and treatment of pulp and periodontal diseases.
漆正楠;曹轶婷;王易维;宋庆博;张培荣;孙顺涛;汪登斌;唐子圣
上海交通大学医学院附属新华医院口腔科,上海(200092)上海交通大学医学院附属新华医院口腔科,上海(200092)上海交通大学医学院附属新华医院口腔科,上海(200092)上海交通大学医学院附属新华医院放射科,上海(200092)上海交通大学医学院附属新华医院放射科,上海(200092)杭州市儿童医院口腔科,浙江 杭州(310005)上海交通大学医学院附属新华医院放射科,上海(200092)上海交通大学医学院附属新华医院口腔科,上海(200092)
医药卫生
5T磁共振成像3T磁共振成像锥形束CT牙髓牙周膜体内成像软组织对比直接成像
5T magnetic resonance imaging3T magnetic resonance imagingcone-beam computed tomogra-phydental pulpperiodontal ligamentin vivo imagingsoft tissue contrastdirect imaging
《口腔疾病防治》 2026 (2)
139-147,9
国家重点研发计划(2022YFC2402105)上海交通大学医学院附属新华医院"学科攀峰计划"项目(XKPF2024B50021,XKPF2024B50024) This study was supported by the grants from the National Key Research and Development Program of China(No.2022YFC2402105)the Construction Project of the"Discipline Peak-Climbing Plan"of Xinhua Hospital,Shanghai Jiao Tong University School of Medicine(No.XKPF2024B50021,No.XKPF2024B50024).
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