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[锥形束计算机断层扫描与传统放射成像技术在颞下颌关节骨关节炎诊断评估中的应用比较]

[Diagnostic evaluation of the temporomandibular joint osteoarthritis using cone beam computed tomography compared with conventional radiographic technology].

作者信息

Meng Juan-hong, Zhang Wan-lin, Liu Deng-gao, Zhao Yan-ping, Ma Xu-chen

机构信息

Department of Oral Maxillofacial Surgery, Peking University School & Hospital of Stomatology, Beijing 100081, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2007 Feb 18;39(1):26-9.

Abstract

OBJECTIVE

Osteoarthritic lesions of Temporomandibular joint(TMJ) were assessed by dental cone beam computed tomography(CBCT), and compared with conventional radiographic technology.

METHODS

The study was conducted retrospectively on 511 joints of 350 patients, who had undergone dental CBCT, panoramic radiography, transcranial projection and transpharygeal projection of TMJ. The results were compared and the accuracy with CBCT was assessed. The types of osseous condylar abnormalities were observed.

RESULTS

(1) The occurrence of osteoarthritis in male and female were 59.04% and 69.66%, respectively, with no significant difference. (2) Compared with CBCT, panoramic radiography, transpharygeal projection examination showed no significant difference, with the accuracy being 90.64% and 94.10%, respectively; However, transcranial projection indicated a significant difference in comparison with CBCT and the accuracy was 86.97%. (3) A higher occurrence of osteoarthritic lesions of the condyle was sclerosis (39.86%). Bony proliferation or osteophyte (28.18%) and ill-defined cortical bone (18.90%) were followed.

CONCLUSION

Cone beam CT, which reproduces multiple images including axial, coronal and sagittal planes of the joint, provides a complete radiographic investigation of the bony components of the TMJ. It is one of the best choices of imaging diagnosis of TMJ osteoarthritis. Panoramic radiography and transpharygeal projection examination are also good choices for showing osseous condylar abnormalities in the clinic, but transcranial projection examination is inferior.

摘要

目的

采用牙科锥形束计算机断层扫描(CBCT)评估颞下颌关节(TMJ)的骨关节炎病变,并与传统放射技术进行比较。

方法

对350例患者的511个关节进行回顾性研究,这些患者均接受了牙科CBCT、全景放射摄影、颞下颌关节经颅投照和经咽投照。比较结果并评估CBCT的准确性。观察髁突骨质异常的类型。

结果

(1)男性和女性骨关节炎的发生率分别为59.04%和69.66%,无显著差异。(2)与CBCT相比,全景放射摄影、经咽投照检查无显著差异,准确性分别为90.64%和94.10%;然而,经颅投照与CBCT相比有显著差异,准确性为86.97%。(3)髁突骨关节炎病变发生率较高的是硬化(39.86%)。其次是骨质增生或骨赘(28.18%)和皮质骨界限不清(18.90%)。

结论

锥形束CT可重现包括关节轴位、冠状位和矢状位在内的多个图像,能对颞下颌关节的骨质成分进行全面的放射学检查。它是颞下颌关节骨关节炎影像诊断的最佳选择之一。全景放射摄影和经咽投照检查在临床上也是显示髁突骨质异常的良好选择,但经颅投照检查较差。

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