颞下颌关节骨关节病的螺旋CT和锥形束CT影像学比较观察  

A comparative study on the radiographs of spiral CT and cone-beam CT in temporomandibular joint osteoarthrosis

作　　者：刘华蔚[1] 毕文婷 李永锋[1] 王家柱[3] 王照五[3] 胡敏[1] Liu Huawei;Bi Wenting;Li Yongfeng;Wang Jiazhu;Wang Zhaowu;Hu Min(Department of Oral and Maxillofacial Surgery,General Hospital of Chinese PLA,Beijing 100853,China;Department of Stomatology,Beijing First Hospital of Integrated Chinese and Western Medicine,Beijing 100026,China;Department of Oral Radiology,General Hospital of Chinese PLA,Beijing 100853,China)

机构地区：[1]解放军总医院口腔颌面外科,北京100853 [2]北京市第一中西医结合医院口腔科,100026 [3]解放军总医院口腔放射科,北京100853

出　　处：《中华口腔医学杂志》2021年第8期747-752,共6页Chinese Journal of Stomatology

基　　金：国家重点研发计划(2017YFB1104103);解放军总医院青年扶持项目(QNF19017)。

摘　　要：目的观察并比较螺旋CT、锥形束CT在颞下颌关节骨关节病成像中的应用,探讨锥形束CT与螺旋CT检测准确性的差异,为临床诊治提供依据。方法选取2018年1月至2019年12月于解放军总医院口腔颌面外科就诊并诊断为颞下颌关节骨关节病的患者52例,其中男性10例,女性42例,平均年龄38.6岁(21~70岁)。所有患者均经过螺旋CT和锥形束CT检查,由2名口腔放射科医师及2名口腔颌面外科医师分别对每侧颞下颌关节的关节间隙、髁突的骨质病变进行测量评估。根据有无骨关节病将患者的104侧关节分为骨关节病侧(92侧)和正常侧(12侧),比较2组关节的间隙大小及病变检出率,采用SPSS 20.0对数据进行统计学分析。结果螺旋CT组与锥形束CT组在关节各间隙大小及关节位置测量的差异均无统计学意义(P>0.05)。骨关节病侧的前间隙大小及髁突后位比例均大于正常侧,髁突在关节窝内相对位置指数小于正常侧,但差异均无统计学意义(P>0.05)。髁突表面缺损破坏是最常见的类型,螺旋CT对髁突骨质病变[表面缺损破坏(85.6%,89/104)、磨平变短(82.7%,86/104)、髁突骨质硬化(40.4%,42/104)、骨赘(40.4%,42/104)及囊性变(11.5%,12/104)]的检出率与锥形束CT[表面缺损破坏(88.5%,92/104)、磨平变短(86.5%,90/104)、髁突骨质硬化(35.6%,37/104)、骨赘(41.3%,43/104)、囊性变(11.5%,12/104)]差异均无统计学意义(P>0.05)。结论螺旋CT和锥形束CT对显示颞下颌关节骨质改变均显示了良好的准确性和一致性,两者重建的关节各间隙大小基本一致,均可作为临床颞下颌关节骨关节病的常规诊断手段。Objective To observe and compare the radiographs of spiral CT and cone-beam CT(CBCT)in the imaging of temporomandibular joint osteoarthrosis(TMJOA)and to explore the difference between CBCT and spiral CT in detection accuracy so as to provide references for clinical diagnosis and treatment.Methods A total of 52 patients with TMJOA diagnosed in the Department of Oral and Maxillofacial Surgery,General Hospital of Chinese PLA,from January 2018 to December 2019 were selected.There were 10 males and 42 females,with an average age of 38.6 years(21-70 years).All patients underwent spiral CT and CBCT examinations.Two oral radiologists and two oral and maxillofacial surgeons measured and evaluated the joint spaces and condylar bone lesions of each side of temporomandibular joint.According to the presence or absence of osteoarthrosis,the patients were divided into osteoarthrosis group(92 sides)and non osteoarthrosis group(12 sides).The mean size of joint spaces and the detection rate of lesions were compared between the two groups.SPSS 20.0 was used to analyze the data.Results There was no significant difference between the measurements of joint space size and joint position in the spiral CT group and the CBCT group(P>0.05).The mean size of the anterior space and the ratio of the posterior condyle in the osteoarthrosis side were larger than that in the normal side.The linear percentage index was smaller in the osteoarthrosis side than that in the normal side indicating that the position of the posterior condyle in the osteoarthrosis side was deviated.However,the difference was not statistically significant(P>0.05).Both spiral CT and CBCT showed good consistency in displaying condylar osteopathy.The most common types of condylar osteopathy was surface defect.The detection rates of defects by spiral CT were surface erosion(85.6%,89/104),articular surface flattening and shortening(82.7%,86/104),subcortical sclerosis(40.4%,42/104),osteophyte(40.4%,42/104)and subcortical cyst(11.5%,12/104)respectively.The detection rates of def

关 键 词：颞下颌关节 骨关节病 锥束计算机体层摄影术 体层摄影术 螺旋计算机 

分 类 号：R782.6[医药卫生—口腔医学] R816.98[医药卫生—临床医学]