基于光谱CT的钙抑制技术评估颞下颌关节紊乱病患者关节盘位置  

To evaluate the disk position of the temporomandibular joint using calcium suppressed spectral-based CT images in the patients with temporomandibular disorder

作　　者：张晓欢[1] 樊文萍[1] 刘梦琦[1] 孟庆林 邓薇薇 王燕一[3] 胡敏[4] 陈志晔[1] Zhang Xiaohuan;Fan Wenping;Liu Mengqi;Meng Qinglin;Deng Weiwei;Wang Yanyi;Hu Min;Chen Zhiye(Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA,Sanya 572013,China;Clinical Science,Philips Healthcare China,Shanghai 200072,China;Department of Stomatology,Hainan Hospital of General Hospital of Chinese PLA,Sanya 572013,China;Department of Oral and Maxillofacial Surgery,General Hospital of Chinese PLA,Beijing 100853,China)

机构地区：[1]解放军总医院海南医院放射科,三亚572013 [2]飞利浦中国临床科学部,上海200072 [3]解放军总医院海南医院口腔科,三亚572013 [4]解放军总医院口腔颌面外科,北京100853

出　　处：《中华口腔医学杂志》2020年第2期93-97,共5页Chinese Journal of Stomatology

摘　　要：目的探索钙抑制光谱CT技术在评估颞下颌关节盘位置及测量关节盘后带厚度中的应用。方法对2019年2至7月解放军总医院海南医院放射科门诊就诊的23例颞下颌关节紊乱病患者[平均年龄23岁(12~62岁),男性14例,女性9例]行MRI斜矢状位、斜冠状位质子密度加权成像及光谱CT扫描,共纳入可评估关节45侧,依扫描设备分为MRI测量组及钙抑制光谱CT测量组。采用钙抑制算法对光谱CT进行去钙处理,并重建斜矢状位及冠状位钙抑制光谱CT图像。基于斜矢状位及冠状位图像评估关节盘位置,基于斜矢状位图像测量关节盘后带最大厚度。结果45侧颞下颌关节盘位置在MRI图像及钙抑制光谱CT图像上基本一致。MRI测量组与钙抑制光谱CT测量组所测后带厚度的组内相关系数为0.843(0.712,0.914),Bland-Altman图分析MRI与钙抑制光谱CT测量关节盘后带厚度的差值点[95.6%(43/45)]位于95%一致性界限内。Wilcoxon配对检验提示MRI测量组[2.57(1.76,3.65)mm]与钙抑制光谱CT测量组[2.67(1.74,4.56)mm]差异无统计学意义(P=0.07)。结论钙抑制光谱CT成像可以准确评估关节盘位置及关节盘后带厚度。Objective To evaluate the application of calcium suppressed(CaSupp)spectral CT technique in evaluating disk position and measuring the thickness of the posterior band of temporomandibular joint(TMJ).Methods The twenty-three temporomandibular disorder patients[mean age 23(12~62)years,male/female=14/9]were performed with oblique sagittal and coronal proton density weighted imaging(PDWI)and spectral CT scans from February to July,2019 in Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA,and 45 TMJ joints were evaluated.The subjects were classified into two groups according to the scanning modalities:MRI measurement group and CaSupp spectral-based CT group.The CaSupp technique were applied with the spectral-based CT images and CaSupp images were generated.The oblique sagittal and coronal CaSupp imaged were reformatted by perpendicular to the long axis of the condyle.The TMJ disk positions were evaluated on oblique sagittal and coronal images,and the maximal disk thickness were measured on the oblique sagittal images.Results The joint position was basically consistent on MRI and CaSupp images for the 45 TMJ joints.The intra-class coefficient value was 0.843(0.712,0.914)for the measurement of the posterior band of the TMJ disk between MRI and CaSupp images.Bland-Altman presented that the[95.6%(43/45)]points with the difference located in the 95%agreement interval.Wilcoxon paired text demonstrated that there was no significant different for the thickness of the posterior band between MRI[2.57(1.76,3.65)mm]and CaSupp images[2.67(1.74,4.56)mm](P=0.07).Conclusions The CaSupp spectral-based CT could be used to evaluated the TMJ disk position and the thickness of the posterior band.

关 键 词：颞下颌关节功能紊乱综合征 磁共振成像 光谱CT 钙抑制技术 

分 类 号：R7[医药卫生—临床医学]