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Comparison of landmark position between conventional cephalometric radiography and CT scans projected to midsagittal plane

3차원 CT자료에서 선정된 계측점을 정중시상면으로 투사한 영상과 두부계측방사선사진상의 계측정의 위치 비교

  • Park, Jae-Woo (Department of Orthodontics, Kooalldam Dental Hospital) ;
  • Kim, Nam-Kug (Department of Industrial Engineering, Seoul National University) ;
  • Chang, Young-Il (Department of Orthodontics, School of Dentistry, Seoul National University)
  • Published : 2008.12.30

Abstract

Objective: The purpose of this study is to compare landmark position between cephalometric radiography and midsagittal plane projected images from 3 dimensional (3D) CT. Methods: Cephalometric radiographs and CT scans were taken from 20 patients for treatment of mandibular prognathism. After selection of land-marks, CT images were projected to the midsagittal plane and magnified to 110% according to the magnifying power of radiographs. These 2 images were superimposed with frontal and occipital bone. Common coordinate system was established on the base of FH plane. The coordinate value of each landmark was compared by paired t test and mean and standard deviation of difference was calculated. Results: The difference was from $-0.14{\pm}0.65$ to $-2.12{\pm}2.89\;mm$ in X axis, from $0.34{\pm}0.78$ to $-2.36{\pm}2.55\;mm$ ($6.79{\pm}3.04\;mm$) in Y axis. There was no significant difference only 9 in X axis, and 7 in Y axis out of 20 landmarks. This might be caused by error from the difference of head positioning, by masking the subtle end structures, identification error from the superimposition and error from the different definition.

본 연구는 두부계측방사선사진에서 선정한 계측점과, 3차원 CT영상에서 계측점을 선정하고 이를 정중시상면으로 투영하였을때 두 계측점 사이의 위치적 연관성에 대해 알아보고자 시행하였다. III급 부정교합을 주소로 서울대학교 치과병원에 내원한 환자 20명을 대상으로 술 전에 CT와 두부방사선사진을 촬영하였다. CT자료에서 계측점을 선정하고, 정중시상면을 기준으로 투사영상을 얻은 후에 이것을 110%로 확대하였다. 전두면과 후두골의 외연을 기준으로 두부방사선사진 투사도와 CT자료의 정중시상면 투사영상을 중첩하고, FH평면을 기준으로 공통 좌표계를 설정하였다. 이 좌표계를 기준으로 얻은 계측점 좌표값 차이의 평균과 표준편차를 구하고 paired t test를 시행하였다. X축은 $-0.14{\pm}0.65$에서 $-2.12{\pm}2.89\;mm$, Y축은 $0.34{\pm}0.78$에서 $-2.36{\pm}2.55\;mm$ ($6.79{\pm}3.04\;mm$)의 범위를 보였으며, 20개의 계측점 중 X축은 9개에서, Y축은 7개에서 통계적으로 유의한 차이가 없는 것으로 나타났다. 이러한 오차는 촬영자세에 따라 악골의 위치가 변화한 경우, 골단부에 위치함으로써 주변구조물에 가려진 경우, 해부학적 구조물의 중첩에 따른 식별오차, 계측점의 정의가 다른 경우 발생할 수 있다.

Keywords

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