髁突矢状骨折CT和MRI诊断及其相关性研究  

A comparative study of two imaging techniques for the diagnosis of sagittal fracture of mandible condyle

作　　者：段登辉[1] 张益[2] 

机构地区：[1]北京大学口腔医学院·口腔医院综合科,100081 [2]北京大学口腔医学院·口腔颌面外科,100081

出　　处：《中华口腔医学杂志》2010年第1期2-5,共4页Chinese Journal of Stomatology

基　　金：国家自然科学基金（30572047）

摘　　要：目的通过CT和MRI检查，研究髁突矢状骨折后骨折移位和关节盘移位的相关性。方法对26例（41侧）髁突矢状骨折CT检查，将骨折分为：裂隙型、移位型和脱位型。根据MRI检查结果将关节盘的移位程度分为A型移位、B型移位；按照异常颞后附着的形态分为拉长型和断裂型。19例（32侧）同时进行CT和MRI检查。结果41侧髁突矢状骨折的CT结果显示：裂隙型5侧（12％）、移位型18侧（44％）、脱位型18侧（44％）。在MRI斜矢状位上，裂隙型骨折5侧，关节盘位于正常位置；移位型骨折15侧，其中A型移位3侧，B型移位12侧；脱位型骨折12侧，关节盘均为B型移位。关节盘颞后附着形态：裂隙型骨折中4侧（4／5）正常形态；移位型骨折中14侧（14／15）颞后附着拉长；12侧脱位型骨折均颞后附着断裂。髁突矢状骨折20侧（63％）显示关节上腔积液；裂隙型骨折中，1侧（1／5）关节上腔积液；移位型和脱位型骨折中，分别有13侧（13／15）和6侧（6／12）关节上腔积液。结论髁突矢状骨折后，关节积液、关节盘移位和颞后附着形态与骨折块的移位程度有关。Objective To investigate the relationship between fractured fragment and joint disc displacement after sagittal fracture of mandibular condyle （SFMC）. Methods based on CT examination, SFMC were classified into tissue, displacement and dislocation type. Based on oblique sagittal MRI examination, the displacement of joint disc was grouped into type A and type B. Abnormal superiorposterior attachment was classified into elongation and avulsion type. Results CT exmination were taken in 26 patients with 41 SFMC. There were 5 SFMC （12%） with tissue type, 18 SFMC （44%） with displacement type and 18 SFMC （44%） with dislocation type. Both CT and MRI examination were taken in 19 patients with 32 SFMC. There were 27 （84%） SFMC with disc displacement. Five SFMC with type tissue showed no signs of disc displacement. Among 15 SFMC with type displacement, there were 3 cases with type A disc displacement and 12 cases with type B disc displacement. All the dislocated SFMC （12 cases） were type B disc displacement. In term of superiorposterior attachment figures, 4 cases （4/5） of type tissue SFMC showed normal 14 cases （ 14/15 ） of the displacement SFMC showed elongated and all cases with dislocated SFMC showed sign of avulsion. There were 20 cases（63% ）showing superior joint effusion. There were 13 cases （13/15） with displaced SFMC and 6 cases with dislocated SFMC showing joint effusion. One case with tissue SFMC showed no sign of joint effusion. Conclusions Joint effusion, disc displacement and abnormal superiorposterior attachment were related to the displacement of condyle which was involved with SFMC.

关 键 词：骨折 下颌骨髁状突 颞下颌关节盘 

分 类 号：R782.4[医药卫生—口腔医学]