Takahashi A, Murakami S, Nishiyama H, Sasai T, Fujishita M, Fuchihata H
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Osaka University, Japan.
Oral Surg Oral Med Oral Pathol. 1992 Aug;74(2):243-50. doi: 10.1016/0030-4220(92)90390-c.
One hundred thirty-one arthrographic examinations of temporomandibular joints were performed on 119 patients. The relationships between clinical symptoms, tomographic findings, and soft-tissue perforation were examined. Perforations of the articular disk or posterior attachment were revealed in 58 joints. Joints with crepitation showed a high frequency of perforation (20 of 22). Pain in the joint area and limitation of opening correlated to disk reduction. Perforations were observed in 12 of 21 joints with continuous pain. Osseous changes were detected in 89 joints. Joints with abnormal radiodensity (erosion, sclerosis) combined with abnormal shape (pocket erosion, osteophyte formation, deformity) showed a high frequency of perforation (41 of 45), which corresponded to 84% in this study. In those cases with osseous change or crepitation, positive predictive values of perforation were both 91%. These types of osseous change and their clinical significance might predict soft-tissue perforation with high accuracy before an arthrogram is performed.
对119例患者进行了131次颞下颌关节造影检查。研究了临床症状、断层扫描结果与软组织穿孔之间的关系。在58个关节中发现了关节盘或后附着处的穿孔。有摩擦音的关节穿孔发生率较高（22个关节中有20个）。关节区域疼痛和开口受限与盘移位有关。在21个持续疼痛的关节中有12个观察到穿孔。在89个关节中检测到骨质改变。具有异常放射密度（侵蚀、硬化）并伴有异常形态（袋状侵蚀、骨赘形成、畸形）的关节穿孔发生率较高（45个关节中有41个），在本研究中占84%。在那些有骨质改变或摩擦音的病例中，穿孔的阳性预测值均为91%。这些类型的骨质改变及其临床意义可能在关节造影检查前就能高精度地预测软组织穿孔。
