Brandlmaier I, Rudisch A, Bodner G, Bertram S, Emshoff R
Department of Oral and Maxillo-Facial Surgery, University of Innsbruck, Innsbruck, Austria.
J Oral Rehabil. 2003 Aug;30(8):796-801. doi: 10.1046/j.1365-2842.2003.01063.x.
The purpose of this study was to determine whether 12.5 MHz ultrasonography (US) could be used to assess the presence or absence of temporomandibular joint (TMJ) internal derangement (ID). In 48 consecutive patients with TMJ disorders 192 TMJ positions were investigated by US to analyse the functional disc-condyle relationship (DCR). In order to compare the respective findings with those of a diagnostic method offering a high accuracy, coronal and sagittal magnetic resonance imaging was carried out immediately afterwards. With US showing a sensitivity of 0.58 and 0.75, and a specificity of 0.92 and 0.84 for disc displacement with and without reduction, the data revealed US to be marginal in detecting the presence, but sensitive in detecting the absence of the respective types of a TMJ ID. In addition, with a positive predictive value of 0.83 and 0.71, and a negative predictive value of 0.81 and 0.87 for disc displacement with and without reduction, the results indicate that US may be insufficient in establishing a correct diagnosis for the presence or absence of the respective types of TMJ ID. Regarding the diagnosis of absence or presence of TMJ ID, the results demonstrate high-resolution (HR)-US to be sensitive in detecting the absence, and reliable in predicting the presence of TMJ ID. In view of the fact that the 12.5 MHz US technique proved to be a reliable diagnostic aid for the detection of normal, and the prediction of abnormal DCR, the results of this study should be of further interest and encourage research in its potential uses and diagnostic capabilities.
本研究的目的是确定12.5兆赫超声检查（US）是否可用于评估颞下颌关节（TMJ）内部紊乱（ID）的存在与否。在48例连续的颞下颌关节紊乱患者中，对192个颞下颌关节位置进行了超声检查，以分析功能性盘-髁关系（DCR）。为了将各自的检查结果与具有高准确性的诊断方法的结果进行比较，随后立即进行了冠状位和矢状位磁共振成像。超声检查对于伴有和不伴有复位的盘移位的敏感性分别为0.58和0.75，特异性分别为0.92和0.84，数据显示超声在检测颞下颌关节ID各类型的存在方面效果一般，但在检测不存在相应类型方面较为敏感。此外，对于伴有和不伴有复位的盘移位，阳性预测值分别为0.83和0.71，阴性预测值分别为0.81和0.87，结果表明超声在确定颞下颌关节ID各类型的存在与否的正确诊断方面可能不足。关于颞下颌关节ID存在与否的诊断，结果表明高分辨率（HR）-US在检测不存在方面较为敏感，在预测存在方面较为可靠。鉴于12.5兆赫超声技术被证明是检测正常情况以及预测异常DCR的可靠诊断辅助手段，本研究结果应会引发更多关注，并鼓励对其潜在用途和诊断能力进行研究。
