冠突过长患者的临床表现及磁共振影像学分析  

Clinical and magnetic resonance imaging imaging analysis of hyperplasia of the coronoid process

作　　者：陈海香 王元银[2] 蒋盼 Chen Haixiang;Wang Yuanyin;Jiang Pan(Department of Stomatology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China;College&Hospital of Stomatology,Anhui Medical University,Key Lab.of Oral Diseases Research of Anhui Province,Hefei 230032,China)

机构地区：[1]中国科学技术大学附属第一医院口腔医学中心,合肥230001 [2]安徽医科大学口腔医学院,安徽医科大学附属口腔医院,安徽省口腔疾病研究重点实验室,合肥230032

出　　处：《中华口腔医学研究杂志（电子版）》2024年第3期169-174,共6页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：中国科学技术大学附属第一医院医学人工智能联合基金(MAI2022Q016)。

摘　　要：目的分析2例成年冠突过长患者的临床及磁共振成像(MRI)影像学表现。方法回顾性分析经临床确诊的2例冠突过长患者(冠突过长组)与71例颞下颌关节紊乱疾病患者的100侧正常关节MRI资料(正常对照组)。所有患者均接受3.0T MRI设备的颞下颌关节检查,利用pyradiomics软件处理得到肌肉纹理参数,采用Mann-Whitney U检验并进行组间比较。结果2例冠突过长患者均表现出低角宽面型的特征,张口度分别为20及22 mm,被动张口度无改善,张口型正常,双侧关节区无弹响或疼痛。口内检查为前牙内倾型深覆,后牙磨耗。MRI表现为颞肌及咬肌的体积增大,关节盘髁关系正常,关节盘变性,髁突骨质光滑连续。冠突过长组的颞肌及咬肌的能源、总能量、灰度不均匀性、网格体积和体素体积等参数均显著高于正常对照组(P<0.05)。然而,冠突过长组翼外肌在这些参数上与正常对照组相比差异无统计学意义(P>0.05)。结论2例成年冠突过长患者MRI影像学表现为颞肌及咬肌体积增大,对于了解冠突过长的发病机制具有重要意义。Objective Our objective was to conduct a comprehensive analysis of the clinical symptoms and magnetic resonance imaging(MRI)findings in two adult patients with hyperplasia of the coronoid process(CPH).Methods A retrospective study was conducted,analyzing two patients clinically diagnosed with an elongated coronoid process(CPH group),along with MRI data from 100 normal joints of 71 patients diagnosed with temporomandibular joint disorders(control group).All participants underwent temporomandibular joint examination using a 3.0T MRI device.The obtained images were post-processed using pyradiomics software to extract muscle texture feature parameters,and a comparative analysis using the Mann-Whitney U test was performed between the two groups.Results Both patients with an elongated coronoid process exhibited traits of a low-angle,wide face type,with mouth opening degrees of 20 mm and 22 mm,respectively,and no improvement in passive mouth opening.The pattern of mouth opening remained normal,with no clicking or pain in the joint area.Intraoral examination revealed an endoclination deep bite of the anterior teeth and wear on the posterior teeth.MRI results showed an increase in the volume of the temporal and masseter muscles,with a normal disc-condyle relationship,but degenerative changes in the articular disc and a smooth and continuous surface of the condylar bone.In the elongated coronoid process group,the energy,total energy,gray-level non-uniformity,grid volume and voxel volume of the temporal and masseter muscles were significantly higher than those in the control group(P<0.05).However,these parameters for the external pterygoid muscle showed no statistically significant difference compared to the control group(P>0.05).Conclusions The MRI imaging of two adult patients with an elongated coronoid process showed an increased volume of the temporal and masseter muscles.This finding was significant for understanding the pathogenic mechanism of CPH.

关 键 词：冠突过长 颞肌 咬肌 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R78[医药卫生—诊断学]