高分辨率超声在颞下颌关节盘前移位诊断中的应用价值  

Application Value of High Resolution Ultrasound in the Diagnosis of Anterior Displacement of Temporomandibular Joint

作　　者：程琳 宫玉榕 张洁 陈晶晶 CHENG Lin;GONG Yurong;ZHANG Jie;CHEN Jingjing(Department of Ultrasound,Fujian People's Hospital Affiliated to Fujian University of Chinese Medicine(Fujian Province People's Hospital),Fuzhou 350004,China;Department of Rehabilitation Medicine,Fujian People's Hospital Affiliated to Fujian University of Chinese Medicine(Fujian Province People's Hospital),Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院(福建省人民医院)超声医学科,福州350004 [2]福建中医药大学附属人民医院(福建省人民医院)康复医学科,福州350004

出　　处：《中国医药指南》2024年第29期137-139,共3页Guide of China Medicine

摘　　要：目的分析高分辨率超声(HR-US)对于颞下颌关节盘前移位(ADD)的诊断价值。方法将我院于2022年3月至2023年3月收治的52例疑似ADD患者为研究对象,均实施HR-US检查与X线检查,以MRI确诊为金标准,计算HR-US与X线对ADD的诊断效能及一致性,绘制受试者工作曲线(ROC),评估两种检查方式的诊断曲线下面积(AUC);HR-US下测量对比ADD患者与非ADD患者闭口位、开口度为1.5 cm、开口度3.0 cm时颞下颌关节外侧囊-髁的距离。结果HR-US对ADD的诊断结果与确诊结果之间的一致性较高(Kappa=0.82),X线检查的Kappa为0.48,一致性中等;ROC曲线显示,HR-US诊断AUC为0.926,X线诊断AUC则为0.759。ADD患者闭口位、开口度1.5cm、3.0cm时颞下颌关节外侧囊-髁距离均大于非ADD患者(均P<0.05)。结论ADD患者应用HR-US诊断具有较为理想的可行性,可借助闭口位或不同程度开口度的颞下颌关节外侧囊-髁距离进行疾病评估,临床适用性较高。objective To analyse the high resolution ultrasound(HR-US)for the anterior disc below(ADD)diagnostic value.Methods Fifty-two patients with suspected ADD admitted to our hospital from March 2022 to March 2023 were selected as study subjects.All of them underwent HR-US examination and X-ray examination,and were confirmed by MRI.The diagnostic efficacy and consistency of HR-US and X-ray for ADD were calculated,and receiver operating curve(ROC)was drawn.The area under the diagnostic curve(AUC)of the two tests was evaluated;measurements under HR-US comparing the lateral capsule-condyle distance of the temporomandibular joint in the closed mouth position,with an opening of 1.5 cm,and with an opening of 3.0 cm in patients with ADD versus those without ADD.Results The concordance between diagnostic and confirmatoryfindings for ADD with HR-US(Kappa=0.82),and with X-ray(Kappa=0.48),medium consistency.The ROC curves showed an AUC of 0.926 for HR-US diagnosis and 0.759 for X-ray diagnosis.The lateral capsule-condyle distance of the temporomandibular joint was greater in patients with ADD than in non-ADD patients in the closed-mouth position,and at openings of 1.5 cm and 3.0 cm(all P<0.05).Conclusions The application of HR-US in the diagnosis of ADD patients has ideal feasibility,and the disease can be evaluated by the temporomandibular joint lateral capsular-condylar distance value of closed mouth position or different degrees of opening position,which has high clinical applicability.

关 键 词：颞下颌关节紊乱病 颞下颌关节盘前移位 高分辨率超声 

分 类 号：R782.6[医药卫生—口腔医学]