Periapical Diseases Clinical Trial
Official title:
The Accuracy of Magnetic Resonance Imaging in Diagnosing Endodontic Periapical Lesion
The radiolucent periapical jaw lesions of 34 patients, which were surgically enucleated, were
investigated by two radiologists using MRI, based on the same six criteria, to categorize the
lesions as granulomas or radicular cysts. After apicoectomies, two oral pathologists (blinded
to the radiologist's diagnoses) analyzed all specimens by referring to seven specific
parameters and diagnosed the specimens as granulomas or radicular cysts. The inter-rater
agreements between the radiologists and pathologists in terms of MRI and histological
diagnoses, respectively, along with the discriminant power of the adopted criteria and the
accuracy of the MRI assessments compared with the histopathologic results, were calculated.
A strong inter-rater reliability was observed between the two radiologists (k-statistic =
0.86, p = 0.0001) and the two pathologists (k-statistic = 0.88, p = 0.0001). Reliability was
higher for the radiological (Guttmann's lambda lower bound > 0.6) than histopathological
criteria. The accuracy (true positives plus true negatives) of the radiologists was higher
than that of the pathologists based on receiver operator characteristic analysis (area under
the curve = 0.87 and 0.91, respectively). MRI reliability and accuracy were high and
comparable to histopathological reliability, highlighting the usefulness of this non-invasive
exam as a pre-treatment diagnostic method for periapical endodontic lesions.
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