牙颌面锥形束CT与普通X线检查对颞下颌关节骨关节病诊断价值的比较研究  

Diagnostic evaluation of the temporomandibular joint osteoarthritis using cone beam computed tomography compared with conventional radiographic technology

作　　者：孟娟红[1] 张万林[2] 柳登高[2] 赵燕平[2] 马绪臣[2] 

机构地区：[1]北京大学口腔医学院.口腔医院口腔颌面外科 [2]北京大学口腔医学院.口腔医院口腔颌面放射科

出　　处：《北京大学学报（医学版）》2007年第1期26-29,共4页Journal of Peking University:Health Sciences

摘　　要：目的:比较牙颌面专用锥形束CT(CBCT)与普通X线检查曲面体层片、许勒位片、经咽侧位片对颞下颌关节骨关节病的诊断价值。方法:对350例(511侧)颞下颌关节紊乱病患者采用牙颌面专用CBCT行颞下颌关节检查,与普通X线检查曲面体层、许勒位、经咽侧位的检查结果进行比较,判断其与CBCT检查结果的一致性,并对骨质变化情况进行分类。结果:(1)骨关节病的发生率:男性、女性分别为59.04%和69.66%,两者之间差异无统计学意义。(2)曲面断层和经咽侧位与CBCT检查结果相比,差异无统计学意义,其准确性分别为90.64%和94.10%;而许勒位与CBCT检查结果相比,差异有统计学意义,准确性为86.97%。(3)CBCT检查显示骨关节病中骨质硬化的比例最高,为39.86%,其次骨质增生为28.18%,骨皮质模糊为18.90%。结论:CBCT可以在轴位、矢状位和冠状位以及多个层面上准确地反映髁突在关节窝中位置及其骨质改变情况,在颞下颌关节病临床诊断中具有重要应用价值,曲面断层和经咽侧位片亦可较好地显示颞下颌关节骨质病变,而许勒位片则相对较差。Objective： Osteoarthritic lesions of Temporomandibular joint（TMJ） were assessed by dental cone beam computed tomography（ CBCT）, and compared with conventional radiographic technology. Methods： The study was conducted retrospectively on 511 joints of 350 patients, who had undergone dental results CBCT ,panoramic radiography, transcranial projection and transpharygeal projection of TMJ . The were compared and the accuracy with CBCT was assessed. The types of osseous condylar abhorrealities were observed. Results： （ 1 ） The occurrence of osteoarthritis in male and female were 59.04% and 69.66%, respectively, with no significant difference. （2） Compared with CBCT, panoramic radiography,transpharygeal projection examination showed no significant difference, with the accuracy being 90.64% and 94.10%, respectively; However, transcranial projection indicated a significant difference in comparison with CBCT and the accuracy was 86.97%. （3） A higher occurrence of osteoarthritic lesions of the condyle was sclerosis （39.86%）. Bony proliferation or osteophyte （28.18%） and ill-defined cortical bone （18.90%） were followed. Conclusion： Cone beam CT, which reproduces multiple images including axial, coronal and sagittal planes of the joint, provides a complete radiographic investigation of the bony components of the TMJ. It is one of the best choices of imaging diagnosis of TMJ osteoarthritis. Panoramic radiography and transpharygeal projection examination are also good choices for showing osseous condylar abnormalities in the clinic, but transcranial projection examination is inferior.

关 键 词：颞下颌关节 骨关节炎 体层摄影术 x线计算机 放射摄影术 

分 类 号：R782.6[医药卫生—口腔医学]