COMMCAT IS-2000 Imaging System^<TM>による顎関節断層撮影法の検討

COMMCAT IS-2000^は顎顔面領域専用の断層エックス線撮影装置で,顎関節の矢状断および冠状断撮影の機能を有する。本装置の顎関節撮影における有用性をエックス線不透過性の鋼鉄製マーカーを付けた4個のヒト乾燥頭蓋骨を用いて検討した。スライス位置の正確性を調べるため下顎頭の表面中央にマーカーを固定し,マーカー直上,それより近心,遠心にそれぞれ1mm,2mm離れた計5点に対して矢状断撮影を行ったところ,スライス位置の誤差は±1mmの範囲内であった。写真の寸法精度を調べるため,下顎頭の実測値と断層写真上での寸法をデジタルキャリパーを用いて比較した。両者の差は前後径では平均0.43mm,近遠心径では平均0.52mmであった。断層軌道および断層厚さの違いが写真画質におよぼす影響を調べた。同一撮影条件下ではhypocycloidal軌道で1mmの断層厚さで撮影した場合,ぶれや周囲の構造物の写り込みが少ないため,最も写真画質が良好であることがわかった。以上の結果よりCOMMCAT IS-2000^はTMJの骨構造を画像化する上で有用な診断装置であることが示唆された。
The COMMCAT IS-2000^ (Imaging Sciences International, Hatfield, PA, USA) is a tomographic machine for scanning the dentomaxillofacial region and is capable of imaging the sagittal and coronal sections of the temporomandibular joint (TMJ). The feasibility and accuracy of tomography for the TMJ were examined by use of the COMMCAT IS-2000^ and four dried human skulls with radiopaque steel markers. To assess the setting accuracy of the slice position, a steel marker was fixed at the center of the superior surface of the condyle, and images of five sagittal sections were taken, i.e., directly above the marker and 1 mm and 2 mm distance from it in both the medial and distal planes. The deviation of the slice position was found to be within ± 1 mm for all test subjects. To evaluate the dimensional accuracy of this method, the difference between the actual value and the graphically observed value with respect to the tomographic image of the condyle was examined using a digital caliper. The difference between values for the anteroposterior distance was 0.43 mm and that for the mediolateral distance was 0.52 mm. The effect of the difference in tomographic motion and slice thickness on the image quality was then evaluated. Under identical exposure conditions, hypocycloidal tube motion and the slice thickness of 1 mm produced the best image quality because blurring of the image and the degree of superimposition of the surrounding structures were minimal. These results suggest that the COMMCAT IS-2000^ is a high-quality diagnostic tool for visualizing the bone structure of the TMJ.