牙颌面专用CT颞下颌关节造影的临床应用  

Temporomandibular joint disc displacement: diagnosis by arthrography with dental volumetric computerized tomography

作　　者：赵燕平[1] 马绪臣[1] 傅开元[1] 宋小侠[1] 

机构地区：[1]北京大学口腔医学院颞下颌关节病及口颌面痛诊治中心,100081

出　　处：《中华口腔医学杂志》2003年第5期321-323,I001,共4页Chinese Journal of Stomatology

摘　　要：目的　探讨牙颌面专用CT颞下颌关节 (temporomandibularjoint ,TMJ)造影对关节盘移位及关节骨结构的诊断效果。方法　对 10 9例 (119侧 )TMJ行牙颌面专用CT关节造影检查 ,将关节盘移位分为 5型 ,髁突骨质改变分为 4型。结果　① 119侧关节均有不同类型的关节盘移位 ,其中 84侧仅有关节盘前移位 ;另 35例则为关节盘旋转移位和侧向移位。②骨关节病的发生率 :男性、女性分别为 6 0 0 %和 6 1.7% ;骨关节病的发生率与关节盘移位类型无关 (χ2 =1.5 6 ,P >0 .0 5 )。③ 73侧骨关节病关节中 ,4 9侧 (6 7.1% )病变发生于髁突外侧 ,8侧病变发生于髁突内侧 ,另有 5侧髁突骨质改变部位不能确定。结论　TMJ造影牙颌面专用CT技术可同时多层面显示关节盘及关节骨性结构的病变 ,尤其是可对关节盘旋转移位及侧向移位、关节盘穿孔等作出准确诊断 。Objective Temporomandibular joint sideways and rotational disc displacement was assessed by arthrography with dental volumetric computerized tomography. Methods The study was conducted retrospectively on 119 joints of 109 patients (87 famales, 22 males, mean age 31.1 years), who had undergone arthrography with dental volumetric CT in the sagittal and coronal planes. The disc displacements were subdivided into 5 types; condylar abnormalities were subdivided into 4 types. Results Complete anterior disc displacement was the commonest (70.6%) and medial the rarest (0.8%); anterolateral and anteromedial displacements were 18.5% and 10.1% respectively. The types of disc displacements were not correlated with bone lesions. A higher prevalences of bone lesions were found in the lateral poles of condyles. Conclusions Arthrography using dental volume CT can be taken in the sagittal and coronal planes, so the sideways and rotational disc displacements, perforations and bone lesions can be evaluated. It′s superior to conventional arthrography.

关 键 词：牙颌面 CT 颞下颌关节盘 TMJ 诊断 关节造影 TMD 骨结构 

分 类 号：R816.98[医药卫生—放射医学]