Larheim T A, Katzberg R W, Westesson P L, Tallents R H, Moss M E
Department of Maxillofacial Radiology, Faculty of Dentistry, University of Oslo, Norway.
Int J Oral Maxillofac Surg. 2001 Apr;30(2):113-7. doi: 10.1054/ijom.2000.0018.
The purpose of this study was to estimate the frequency and amount of temporomandibular joint (TMJ) fluid, as well as the frequency and type of condyle marrow alterations in asymptomatic volunteers and compare to patients with TMJ pain and dysfunction. Proton-density and T2 weighted magnetic resonance (MR) images of the TMJs of 62 asymptomatic volunteers and 58 symptomatic patients were analysed for fluid and condyle marrow alterations as well as disk position. The amount of fluid (increased T2 signal) was characterized as none, minimal, moderate or marked and related to the disk position. The differentiation between moderate and marked fluid was based on the maximum amount of fluid seen in the volunteers; more than this amount was categorized as marked fluid. The marrow of the mandibular condyle was categorized as normal, edema (increased T2 signal) or sclerosis (decreased proton-density and T2 signal) and related to fluid and disk position. In the 62 asymptomatic volunteers, 50 (81%) had none or minimal and 12 (19%) had moderate TMJ fluid. In the 58 symptomatic patients, 40 (69%) had none or minimal and 18 (31%) had moderate or marked fluid. Both in volunteers and patients, moderate fluid could be seen in joints with normal disk position, but was significantly associated with disk displacement. In the 62 volunteers, no signal abnormalities in the condyle marrow were found. In the 58 patients, six (10%) had abnormal bone marrow. These six patients had disk displacement and two had moderate or marked fluid. Marked fluid and condyle marrow abnormalities were therefore not encountered in any of the asymptomatic volunteers but in about 10% of the patients.
本研究的目的是评估无症状志愿者颞下颌关节(TMJ)液的频率和量,以及髁突骨髓改变的频率和类型,并与患有TMJ疼痛和功能障碍的患者进行比较。分析了62名无症状志愿者和58名有症状患者的TMJ的质子密度和T2加权磁共振(MR)图像,以观察关节液和髁突骨髓改变以及盘状结构位置。关节液的量(T2信号增强)分为无、少量、中度或大量,并与盘状结构位置相关。中度和大量关节液的区分基于志愿者中观察到的最大液量;超过此量则归类为大量关节液。下颌髁突骨髓分为正常、水肿(T2信号增强)或硬化(质子密度和T2信号降低),并与关节液和盘状结构位置相关。在62名无症状志愿者中,50名(81%)无或仅有少量TMJ液,12名(19%)有中度关节液。在58名有症状患者中,40名(69%)无或仅有少量关节液,18名(31%)有中度或大量关节液。在志愿者和患者中,盘状结构位置正常的关节中均可出现中度关节液,但与盘状结构移位显著相关。在62名志愿者中,未发现髁突骨髓信号异常。在58名患者中,6名(10%)有骨髓异常。这6名患者均有盘状结构移位,其中2名有中度或大量关节液。因此,在任何无症状志愿者中均未发现大量关节液和髁突骨髓异常,但在约10%的患者中出现。