颞下颌关节盘移位的MRI表现及其临床诊断价值  

MRI Manifestation of Temporomandibular Joint Disc Displacement and Its Clinical Value

作　　者：刘四斌[1] 周文辉[2] 胡久益[2] 胡道予[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]华中科技大学同济医学院附属荆州医院放射科,湖北434000

出　　处：《放射学实践》2008年第3期268-270,共3页Radiologic Practice

摘　　要：目的:探讨颞下颌关节盘移位的MRI表现及其临床诊断价值。方法:23例共46侧关节盘行斜矢状面和冠状面T1WI、T2WI及T2*WI扫描,分析关节盘在开口位和闭口位上的位置变化和关节盘的形态等。结果:46侧关节盘中有17侧(17/46)正常;可复性关节盘前移位11侧(11/46),主要MRI表现为闭口位时关节盘在髁状突前方,关节结节前下方,开口位时,关节盘回到关节窝正常位置,关节盘可变形伸长,后带膨大,信号基本正常;不可复性关节盘前移位15侧(15/46),主要MRI表现为在闭口位和开口位时关节盘位置均位于髁突前方,关节结节前下方,不回到关节窝内,关节盘形态严重变形,出现圆形、折叠型、伸长型等,关节盘信号基本正常;关节盘内侧移位2侧(2/46),外侧移位1侧(1/46),这两种类型主要MRI表现为关节盘变形,呈低信号改变。结论:MRI可以清楚显示关节盘的位置、结构及盘突关系,对颞下颌关节盘移位有重要的临床诊断价值。Objective：To study the MRI diagnosis of temporomandibular joint disc displacement （TMJDD）. Methods： Oblique sagittal and coronal MR scanning with open-mouth and closed-mouth position were performed using T1WI.T2 WI. 72 · WI sequences for 46 joints in 23 cases. Changes of position and morphology of articular discs in all joints with open-and closed-mouth were analyzed retrospectively. Results：Of the 46 joints, 17 joints （17/46） showed normal disc-condyle relationship （NDCR） and 11 joints （11/46） showed anterior disc displacement with reduction （ADDR）. The major findings of ADDR were as follows：with closed mouth position, articular disc was in front of the condyle process and beneath the articular tubercle ; with opened mouth position, articular disc returned to normal position. The articular disc could be deformed and elongated,the posterior band swelled, the signal intensities were basically normal. Of the joints, 15 joints （15/46） showed anterior disc displacement without reduction （ADDWR） ：the disc located anterior to the condyle, anterior to and beneath the articular tubercle in closed as well as open-mouth position,which could not return to articular fossa, the articular disc deformed seriously, manifested as round, folded or elongated types, etc. with basically normal signal intensities, two joints （2/46） showed inward displacement and one joint showed outward displacement of articular disc. Of these two groups with articular disc deformation, low signal intensities were showed. Conclusion：The position of articular disc, structure of joint, relationship of disc and condyle could be clearly displayed on MRI,which is very helpful in the clinical diagnosis of TMJ disc displacement.

关 键 词：磁共振成像 颞下颌关节 颞下颌关节功能紊乱综合征 

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