锥形束CT颞下颌关节上腔造影在诊断关节盘病变中的应用  

Exploration of temporomandibular disc perforation with cone beam computed tomography arthrography diagnosis

作　　者：许跃[1] 林秋平[1] 林韩[1] 张志光[1] 郑有华[1] 

机构地区：[1]中山大学光华口腔医学院·附属口腔医院,广东省口腔医学重点实验室,广州510055

出　　处：《中华口腔医学研究杂志（电子版）》2016年第5期347-351,共5页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：国家自然科学基金(81271115)

摘　　要：目的：探讨颞下颌关节（TMJ）骨关节病中关节盘前移位、穿孔及髁突骨质改变类型的关系。方法选择中山大学附属口腔医院颞下颌关节专科就诊的96例骨关节病患者共145侧TMJ行锥形束CT（CBCT）关节造影检查，分为关节盘穿孔组和非穿孔组，两组病例以CBCT按照关节盘移位及髁突骨质改变类型进行分类比较，应用SPSS 18.0对关节盘穿孔与关节盘移位类型进行Pearsonχ^2独立性检验，两组间骨质分型构成比进行χ^2检验。结果所有关节发生关节盘前移位，其中124侧为不可复性盘前移位、21侧为可复性盘前移位。86侧TMJ发生关节盘穿孔，59侧关节造影未检出穿孔。关节盘是否发生穿孔与关节盘前移位类型存在相关性（χ^2=6.866，P=0.015），关节盘穿孔组不可复性盘前移位发生率（91.86%）高于非关节盘穿孔组（76.27%）。结论 TMJ骨关节病患者均存在不同程度的关节盘移位，关节盘移位类型与关节盘穿孔相关，髁突骨质改变类型与关节盘是否穿孔无明显相关性。Objectives To explore the relationship of anterior disc displacement,disc perforation and condyle bone defect. Methods A total of 96 cases of osteoarthrosis（145 sides of temporomandibular joint）from Hospital of Stomatology,Sun Yat-sen University,were included and undertook cone beam computed tomography arthrography（CBCT）. They are classified into Perforation Group and Non -perforation Group. The disc displacement and types of perforation were analyzed with Pearson χ^2 method, and the bone defect types between two groups were compared with χ^2 analyses using SPSS 18.0 software. Results Anterior disc displacement was shown in all the joints,among which 124 cases were anterior disc displacement without reduction,and 21 cases were anterior disc displacement with reduction. Disc perforation was confirmed by arthrography in 86 cases. Significant correlation（χ^2=6.866,P=0.015）was found between the types of the anterior disc displacement and the groups of Perforation or Non-perforation. In the Perforation Group,the incidence of anterior disc displacement without reduction（91.86%）was greater than that in the Non-perforation Group（76.27%）. Conclusions The disc displacement can happen in the disc perforation cases. And the types of disc displacement are correlated with the perforation,while the type of condyle bone defect show no significance correlation with the perforation.

关 键 词：颞下颌关节 骨关节病 关节盘穿孔 关节盘前移位 

分 类 号：R782.6[医药卫生—口腔医学]