颞下颌关节滑膜软骨瘤病的MRI表现  

Magnetic Resonance Imaging Findings of Synovial Chondromatosis in the Temporomandibular Joint

作　　者：王玉良[1] 王旭[1] 杨驰[2] 张善勇[2] 

机构地区：[1]滨州医学院附属医院·口腔学院口腔颌面外科,山东滨州256603 [2]上海交通大学附属第九人民医院口腔颌面外科,200011

出　　处：《临床放射学杂志》2009年第3期314-316,共3页Journal of Clinical Radiology

摘　　要：目的探讨颞下颌关节区滑膜软骨瘤病的MRI表现特点。资料与方法搜集7例主诉为颞下颌关节区肿胀、疼痛、杂音或者张口受限患者的MRI影像资料,对其斜冠状面和斜矢状面的张闭口位T1WI、T2WI进行分析。所有病例均经关节镜手术或开放性手术病理证实为滑膜软骨瘤病。结果颞下颌关节滑膜软骨瘤病的MRI表现为:(1)病变区有单个或多个散在软骨小体或钙化游离体(n=7);(2)关节腔大量积液(n=7);(3)关节区软组织肿大(n=5);(4)关节盘形态和位置异常(n=2);(5)下颌髁突骨质异常改变(n=3),表现为骨皮质连续性中断和/或骨髓腔减少;(6)颞骨关节面骨质异常改变(n=2),表现为骨质硬化。结论颞下颌关节滑膜软骨瘤病的MRI表现多为单个或多个散在的软骨小体或钙化游离体伴关节腔大量积液;往往伴有关节区软组织肿胀;少数病例可侵犯邻近的骨质,引起髁突或颞骨关节窝等骨质的破坏或伴有关节盘形态或位置异常。Objective To discuss the characteristic magnetic resonance imaging（MRI） findings of synovial chondromatosis in the temporomandibular joint. Materials and Methods Seven patients with synovial chondromatosis confirmed by histology through arthroscopic surgery or open surgery suffered from pain, swelling, restricted movement of the mandible,or crepitation in the unilateral TMJ region. Closed and open-mouth MRI images including T1 and T2-weighted images were evaluated. Results The MRI abnormal findings of synovial chondromatosis in the temporomandibular joint were （ 1 ） One or more cartilaginous bodies or calcified bodies （ n = 7 ）, （ 2 ） a large amount of synovial fluid （ n = 7 ）, （ 3 ） soft tissue swelling （ n = 5 ）, （4） the disk with abnormal position or shape （ n = 2 ）, （ 5 ） bony erosion of mandibular condyle （ n = 2 ） with cortical bony erosion or decreased cavity of medullary space, （6） bony erosion with sclerosis of the articular eminence and the glenoid fossa （ n = 2）. Conclusion On MRI images, a diagnosis of synovial chondromatosis of the TMJ should be considered when cartilaginous bodies and calcified bodies and the large amount of synovial fluid exist ,when accompanied by the soft tissue swelling, as seen on closed-and open-mouth MRI of the TMJ,with or without any associated severe changes in bony structure, disc shape and position or the extension of the surrounding structures.

关 键 词：颞下颌关节 滑膜软骨瘤病 磁共振成像 临床分析 

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