颞下颌关节损伤的MRI表现  

MRI Manifestation of Temporomandibular Joint after Trauma

作　　者：王化[1] 王霄英[1] 张益[2] 何冬梅[2] 蒋学祥[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]北京大学口腔医院颌面外科

出　　处：《实用放射学杂志》2008年第3期306-308,319,共4页Journal of Practical Radiology

摘　　要：目的研究颞下颌关节(temporomandibular joint,TMJ)损伤的MRI表现,重点观察关节盘的移位及损伤情况。方法13例TMJ损伤的初诊患者,使用3英寸(1英寸=2.54 cm)双颞下颌Dual表面线圈,分别行斜矢状面和斜冠状面T1WI和T2WI的闭口位及张口位扫描。结果13例患者26个TMJ中有20个(20/26,76.9%)发生髁突骨折,其中12例患者的19个(19/20,95%)关节盘随着碎裂的髁突骨折片向前内侧移位,6个(6/20,30%)关节盘可见扭曲、变形。另1例患者为单侧髁突骨折并关节盘断裂(1/20,5%),向外侧移位,其对侧关节盘轻度向前移位。12个TMJ可见关节积液,均见于髁突骨折的关节(12/20,60%)。开口位关节盘的位置较闭口位未见明显变化。结论MRI是TMJ损伤的有效检查方法,有助于判断关节盘形态和位置的改变。Objective To investigate M RI manifestations of temporomandibular joint trauma,emphasized on the displacement and deformation of the meniscus. Methods Thirteen patients with TMJ trauma were examined by MRI with 3 - inch dual surface coils . T1WI and T2WI images in oblique sagittal and coronal plane were acquired in both closed - and open - mouth positions . Results Twenty （ 20/26, 76.9% ） joints had condylar fractures. Nineteen （ 19/20, 95% ） discs in 12 patients displaced anteromedially with the condylar fragments, six （6/20, 30% ） discs showed distortion and deformation. The other one patient had unilateral condylar fracture companied with avulsion and lateral dislocation of ipsilateral disc （ 1/20, 5% ） , and the opposite disc also showed slight anterior displacement. Effusion was observed in 12 （ 12/20, 60% ） joints with condylar fractures. The location of the discs didn＇t show obvious change between closed - and open - mouth positions. Conclusion MRI is an effective method for demonstrating TMJ injuries, and is useful for detecting the changes of morphology and position of the discs.

关 键 词：颞下颌关节 损伤 磁共振成像 

分 类 号：R782.6[医药卫生—口腔医学] R445.2[医药卫生—临床医学]