Tanaka T, Morimoto Y, Masumi S, Tominaga K, Ohba T
Department of Dental Radiology, Kyushu Dental College, Kokurakita-ku, Kitakyushu 803-8580, Japan.
Dentomaxillofac Radiol. 2002 Sep;31(5):305-12. doi: 10.1038/sj.dmfr.4600713.
To evaluate joint effusion in the temporomandibular joint (TMJ) using frequency-selective fat saturation (FS) T2-weighted images and assess this technique. To investigate whether bone marrow abnormalities and magnetic resonance imaging (MRI) findings of internal derangement may be linked to joint effusion in the TMJ in patients with pain.
TMJ effusion was sought on FS T2-weighted images and conventional T2-weighted images in 400 joints from 200 patients with TMJ-related pain. Self-reported pain records were obtained from patients immediately before MRI and images assessed by the amount of TMJ fluid graded bilaterally using reference films by two radiologists. Other parameters recorded included disk displacement categories and condyle marrow abnormalities. The association between the recorded parameters and TMJ effusion judged by FS-sequences or conventional sequences was analysed using chi-square and Kappa tests.
The detection rate of TMJ effusion by FS-sequences was significantly greater than by conventional methods, and the results showed a significant relationship between MRI interpretation of TMJ effusion using FS-sequences or conventional methods and the presence of pain. The correlation between TMJ effusion on FS-sequences and pain was significantly stronger than the conventional method. Kappa test indicated good agreement between pain and MRI TMJ effusion by FS-sequences (kappa = 0.66), but not by conventional sequences (kappa = 0.56). The other parameters showed a similar trend for TMJ-related pain.
FS T2-weighted imaging is useful for detection of TMJ effusion, without known causes and confirms the importance of TMJ effusion as an indicator in patients with TMJ-related pain, bone abnormalities, and disk displacement.
使用频率选择性脂肪饱和（FS）T2加权成像评估颞下颌关节（TMJ）内的关节积液，并评估该技术。调查骨髓异常和颞下颌关节内紊乱的磁共振成像（MRI）表现是否可能与疼痛患者的颞下颌关节积液有关。
在200例患有颞下颌关节相关疼痛患者的400个关节中，通过FS T2加权成像和传统T2加权成像寻找颞下颌关节积液。在MRI检查前立即从患者处获取自我报告的疼痛记录，并由两名放射科医生使用参考片对双侧颞下颌关节液量进行分级评估图像。记录的其他参数包括盘移位类别和髁突骨髓异常。使用卡方检验和Kappa检验分析记录的参数与通过FS序列或传统序列判断的颞下颌关节积液之间的关联。
FS序列对颞下颌关节积液的检出率显著高于传统方法，结果显示使用FS序列或传统方法对颞下颌关节积液进行MRI解读与疼痛的存在之间存在显著关系。FS序列上颞下颌关节积液与疼痛之间的相关性明显强于传统方法。Kappa检验表明，通过FS序列（kappa = 0.66），疼痛与MRI颞下颌关节积液之间具有良好的一致性，但传统序列（kappa = 0.56）则不然。其他参数在颞下颌关节相关疼痛方面显示出类似趋势。
FS T2加权成像有助于检测不明原因的颞下颌关节积液，并证实了颞下颌关节积液作为颞下颌关节相关疼痛、骨质异常和盘移位患者指标的重要性。
