Toni M G, Calderazzi A, Battolla L, De Gaudio C, Mita A
Servizio di Medicina Nucleare, Università, Ospedale S. Chiara, Pisa.
Radiol Med. 1992 Nov;84(5):549-52.
Symptomatic temporomandibular joint dysfunctions may affect about 25% of the adult population, with a smaller though significant percentage of patients experiencing severe impairment. From 1986 through 1991, 107 patients with severe temporomandibular joint symptoms and with various temporomandibular joint disorders were evaluated with conventional radiology and with closed/open-mouth temporomandibular joint tomograms. Single-photon emission-computed tomography (SPECT) and planar imaging were performed on 32 patients using a rotating gamma camera equipped with a general purpose collimator. Transaxial, coronal and sagittal tomoscintigrams were reconstructed. Increased radiotracer uptake in the temporomandibular joint was regarded as a positive finding, and the intensity of temporomandibular joint activity was compared with that of adjacent calvarium using regions of interest. In the 32 patients submitted to scintigraphy, conventional radiology showed no pathologic patterns, while SPECT showed pathologic findings in 31 patients (97% of cases). The patient with normal temporomandibular joint findings on SPECT exhibited abnormal maxillary isotope uptake, ipsilateral to the symptoms. Our results indicate that SPECT is a simple, noninvasive, inexpensive and very sensitive screening test relative to the internal derangement of the temporomandibular joint. Moreover, it provides information which is not available by means of routine bone scans or X-ray studies. Thus, SPECT appears to be the modality of choice for patients whose clinical findings are equivocal or whose symptoms are unclear, and it can guide treatment strategies and be useful in the follow-up.
有症状的颞下颌关节功能障碍可能影响约25%的成年人口，其中有较小比例但数量可观的患者出现严重功能损害。1986年至1991年期间，对107例有严重颞下颌关节症状及各种颞下颌关节疾病的患者进行了传统放射学检查以及闭口/开口位颞下颌关节断层扫描。对32例患者使用配备通用准直器的旋转γ相机进行了单光子发射计算机断层扫描（SPECT）和平面成像。重建了横轴位、冠状位和矢状位断层闪烁图。颞下颌关节中放射性示踪剂摄取增加被视为阳性发现，并使用感兴趣区将颞下颌关节的活动强度与相邻颅骨的活动强度进行比较。在接受闪烁扫描的32例患者中，传统放射学检查未显示病理模式，而SPECT显示31例患者（97%的病例）有病理发现。SPECT检查颞下颌关节结果正常的患者上颌骨出现了与症状同侧的异常同位素摄取。我们的结果表明，相对于颞下颌关节内紊乱，SPECT是一种简单、无创、廉价且非常敏感的筛查方法。此外，它提供了常规骨扫描或X线检查无法获得的信息。因此，SPECT似乎是临床检查结果不明确或症状不清楚患者的首选检查方法，它可以指导治疗策略并在随访中发挥作用。
