The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Reproducibility of asymmetry measurements of the mandible in three-dimensional CT imaging

전산화단층사진을 이용한 하악골 3차원 영상에서 비대칭진단 계측항목의 재현도에 관한 연구

  • Kim, Go-Woon (Department of Orthodontics, School of Dentistry, Chonnam National University) ;
  • Kim, Jae-Hyung (Department of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Lee, Ki-Heon (Department of Orthodontics, School of Dentistry, Chonnam National University) ;
  • Bwang, Hyeon-Shik (Department of Orthodontics, 2nd Stag of Brain Korea 21, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 김고운 (전남대학교 치과대학 교정학교실) ;
  • 김재형 (전남대학교 치과대학 구강내과학교실) ;
  • 이기헌 (전남대학교 치과대학 교정학교실) ;
  • 황현식 (전남대학교 치의학연구소, 2단계 BK21 연구사업단, 치과대학 교정학교실)
  • Published : 2008.10.30
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Abstract

Objective: The purpose of this study was to evaluate the reproducibility of measurements representing asymmetry of the mandible and to identify which landmarks would be more useful in 3-dimensional (3D) CT imaging. Methods: Facial CT images were obtained from forty normal occlusion individuals. Eighteen landmarks were established from the condyle, gonion, and menton areas, and 25 measurements were constructed to represent asymmetry of the mandible; 8 for ramus length, 12 for mandibular body length, 1 for condylar neck length, 2 for frontal ramal inclination, and 2 for lateral ramal inclination. Inter- and intra-examiner reproducibility of the measurements was evaluated. Results: Inter-examiner reproducibility of the measurements proved to be high except for 3 measurements. Intra-examiner reproducibility also proved to be high except for 2 measurements. Inter- and intra-examiner reproducibility of the measurements including Gonion proved to be low. Conclusions: The results of the present study indicate that the landmarks and measurements constructed in 3D CT images can be used for the diagnosis of facial asymmetry.

본 연구는 하악골 3차원 입체영상에서 비대칭계측항목들의 재현도 비교를 통하여 안면비대칭 진단 시 유용한 계측점 설정에 도움이 되고자 시행되었다. 40명의 두경부 전산화단층사진을 이용하여 생성한 3차원 영상에서 하악골 형태를 결정짓는 부위로 하악과두, 하악우각부, 하악정중부를 선택하고 각 부위의 세부위치에 따라, 그리고 측정 시 보는 각도에 따라 구분하여 하악과두의 경우 $Cd_{sup}_{-}_{sup}$ 등 6개, 하악우각부의 경우 $Go_{inf}_{-}_{lat}$ 등 10개, 하악정중부의 경우 $Me_{-}_{ant},\;Me_{-}_{inf}$ 등 총 18개의 계측점을 설정한 후 이를 이용하여 하악골 비대칭 시 좌우 차이를 보일 수 있는 25개의 계측항목을 설정 및 계측한 후 조사자간 및 조사자내의 재현도를 비교 평가하였다. 조사자간 재현도의 경우 25개의 계측항목 중 3개를 제외한 모든 계측항목에서, 조사자내 재현도의 경우 2개 항목을 제외한 모든 계측항목에서 높은 재현도를 보였다. 아울러 본 연구에서 설정한 18개의 계측점 중 $Go_{mid}_{-}_{lat},\;Go_{mid}_{-}_{obl}$가 포함된 계측항목이 조사자간 및 조사자내 재현도가 떨어지는 경향을 보였다. 이상의 면구 결과 본 연구에서 사용된 18개의 계측점 중 16개의 계측점 (과두를 나타내는 $Cd_{sup}_{-}_{sup},\;Cd_{lat}_{-}_{ant},\;Cd_{lat}_{-}_{lat},\;Cd_{post}_{-}_{lat},\;Cd_{post}_{-}_{post},\;S$, 하악우각부를 나타내는 $Go_{int}_{-}_{lat},\;Go_{inf}_{-}_{inf},\;Go_{lat}_{-}_{ant},\;Go_{lat}_{-}_{lat},\;Go_{post}_{-}_{lat},\;Go_{post}_{-}_{post},\;Ag_{-}_{lat},\;Ag_{-}_{inf}$, 하악정중부를 나타내는 $Me_{-}_{ant},\;M_{-}_{inf}$)은 높은 재현도를 보이므로 전산화단층사진을 이용한 하악골 3차원 영상에서 안면비대칭 환자의 진단에 유용하게 사용될 수 있음을 시사하였다.

Keywords

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