Landes Constantin A, Goral Wojciech A, Sader Robert, Mack Martin G
Department of Oral Maxillofacial and Plastic-Facial Surgery, Frankfurt University Medical Centre, Frankfurt, Germany.
Ultrasound Med Biol. 2006 May;32(5):633-9. doi: 10.1016/j.ultrasmedbio.2006.02.1401.
This study determines the value of three-dimensional (3-D) sonography for the assessment of disk dislocation of the temporomandibular joint (TMJ). Sixty-eight patients (i.e.,136 TMJ) with clinical dysfunction were examined by 272 sonographic 3-D scans. An 8- to 12.5-MHz transducer, angulated by step-motor, was used after picking a volume box on 2-D scan; magnetic resonance imaging followed immediately. Every TMJ was scrutinized in closed- and open-mouth position for normal or dislocated disk position. Fifty-three patients had complete data sets, i.e., 106 TMJ, 212 examinations. Sonographic examination took 5 min, with 74% specificity (62% closed-mouth; 85% open-mouth); sensitivity 53% (62/43%); accuracy 70% (62/77%); positive predictive value 49% (57/41%); and negative predictive value 77% (67/86%). This study encourages more research on the diagnostic capacity of 3-D TMJ sonography, with the advantage of multidimensional joint visualization. Although fair in specificity and negative predictive value, sensitivity and accuracy may ameliorate with future higher-sound frequency, real-time 3-D viewing and automated image analysis.
本研究旨在确定三维（3-D）超声检查在评估颞下颌关节（TMJ）盘状移位中的价值。对68例有临床功能障碍的患者（即136个颞下颌关节）进行了272次超声三维扫描检查。在二维扫描中选定容积框后，使用由步进电机控制角度的8至12.5兆赫换能器；随后立即进行磁共振成像检查。对每个颞下颌关节在闭口和开口位进行仔细检查，以确定盘状位置是否正常或移位。53例患者有完整数据集，即106个颞下颌关节，212次检查。超声检查耗时5分钟，特异性为74%（闭口位62%；开口位85%）；敏感性为53%（62/43%）；准确性为70%（62/77%）；阳性预测值为49%（57/41%）；阴性预测值为77%（67/86%）。本研究鼓励对三维颞下颌关节超声检查的诊断能力开展更多研究，其优势在于可进行多维度关节可视化。尽管特异性和阴性预测值尚可，但随着未来更高频率超声、实时三维观察和自动图像分析技术的发展，敏感性和准确性可能会有所提高。
