颞下颌关节紊乱的影像学特征:锥形束CT和MRI效能比较  

Imaging features of temporomandibular joint disorder: comparison of the efficacy of cone-beam CT and MRI

作　　者：陈建荣 丁水清 陈亮 何佳嘉 祁荣兴[3] CHEN Jian-rong;DING Shui-qing;CHEN Liang;HE Jia-jia;QI Rong-xing(Department of Radiology,Nantong Hospital of Stomatology,Nantong 226002;Department of Oral and Maxillofacial Surgery,Nantong Hospital of Stomatology,Nantong 226002;Department of Imaging,Second Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南通市口腔医院放射科,南通226002 [2]南通市口腔医院口腔颌面外科,江苏南通226002 [3]南通大学第二附属医院影像科,江苏南通226001

出　　处：《中国口腔颌面外科杂志》2022年第3期273-276,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:分析颞下颌关节紊乱(temporomandibular joint disorder,TMD)的锥形束CT(cone-beam CT,CBCT)和磁共振成像(magnetic resonance imaging,MRI)特征,对两者的影像特征进行比较。方法:收集2018年8月—2020年5月在南通市口腔医院治疗的45例TMD患者的临床资料,所有患者均于2周内完成CBCT和MRI检查,统计所有患者颞下颌关节(temporomandibular joint,TMJ)和咀嚼肌病变在CBCT和MRI上的特征(包括关节间隙狭窄、骨质破坏、骨质增生硬化、髁突变形、骨质囊样变、关节盘移位、关节囊积液和咀嚼肌病变),并对两者的影像学特征进行比较。采用SPSS 25.0软件包进行数据统计分析。结果:TMD临床分类Ⅰ类疼痛性疾病31例(68.9%),Ⅱ类关节疾病14例(31.1%)。45例患者90个关节中,MRI检出存在TMJ和咀嚼肌病变数(71/90)显著高于CBCT检出的病变数(58/90)(P=0.032),其中MRI检出关节盘移位(19/90)、关节囊积液(28/90)和咀嚼肌水肿(22/90)例数,均显著高于CBCT检出例数(3/90)、(8/90)和(5/90)(P<0.001);CBCT检出骨质增生硬化(18/90)、髁突变形(15/90)例数,显著高于MRI检出例数(8/90)和(6/90)(P<0.05);而CBCT和MRI在检出关节间隙狭窄、骨质破坏和骨质囊样变方面均无统计学差异(P>0.05)。结论:CBCT和MRI在评估TMD方面均有很高价值,其中CBCT在评估骨质方面具有优势,而MRI在评估关节盘和软组织方面有很好效果。PURPOSE:To analyze the features on cone-beam CT(CBCT)and MRI of temporomandibular joint disorder(TMD).METHODS:The data of 45 patients with TMD treated in Nantong Hospital of Stomatology from August 2018 to May 2020 were collected.All patients completed CBCT and MRI within 2 weeks,and the characteristics of TMJ and masticatory muscle lesions on CBCT and MRI were evaluated,including joint space stenosis,bone destruction,bone hyperplasia and sclerosis,condyle deformation,bone cystoid degeneration,articular disc displacement,joint capsule effusion and masticatory muscle lesions.SPSS 25.0 software package was used for data analysis.RESULTS:According to TMD clinical classification,31 cases(68.9%)were classified as type I painful diseases,and 14 cases(31.1%)were classified as type II joint diseases.Among the 90 joints of 45 patients,the number of TMJ and masticatory muscle lesions detected by MRI(71/90)was significantly higher than the number of lesions detected by CBCT(58/90)(P=0.032).Among them,the number of articular disc displacement(19/90),joint capsule effusion(28/90)and masticatory muscle edema(22/90)were significantly higher than the number of cases detected by CBCT which was 3/90,8/90 and 5/90(P<0.001).The number of cases of hyperosteosis(18/90)and condyle mutation(15/90)detected by CBCT was significantly higher than the number of cases detected by MRI which was 8/90 and 6/90(P<0.05).CBCT and MRI had no significant differences in detecting joint space stenosis,bone destruction and cystoid degeneration(P>0.05).CONCLUSIONS:Both CBCT and MRI have high clinical value in evaluating TMD.CBCT has advantages in evaluating bone quality,while MRI has a good effect in evaluating joint discs and soft tissues.

关 键 词：锥形束CT 磁共振成像 颞下颌关节紊乱 

分 类 号：R782.6[医药卫生—口腔医学]