Zhang ShanYong, Yang Chi, Chen MinJie, Fan Xindong, Yun Bai, Peng Yan, Yuan Dan
Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai JiaoTong University, People's Republic of China.
Br J Oral Maxillofac Surg. 2009 Jul;47(5):389-92. doi: 10.1016/j.bjoms.2008.09.007. Epub 2008 Oct 28.
We aimed to evaluate the value of magnetic resonance imaging (MRI) for the diagnosis of intra-articular adhesions of the temporomandibular joint (TMJ). We diagnosed 27 consecutive patients with internal derangement of the TMJ (33 TMJs) between 1 December and 31 July 2003 in our department. All patients were examined by MRI and arthroscopy. The MRI findings were recorded as "positive", "suspicious", or "negative", and were compared with those of arthroscopy to obtain the numbers of true positive, true negative, false positive, and false negative results. Arthroscopy confirmed that 18 of the 33 TMJs contained adhesions. MRI showed that 11 were "positive", 4 were "suspicious", and 18 were "negative". After comparing these results with those of arthroscopy, 7 TMJs were true positives and 4 were false positives of the 11 "positive" TMJs. Three of the 4 "suspicious" TMJs had adhesions. Of the 18 negative TMJs, 10 were true negatives and 8 were false negatives. We concluded that the diagnostic accuracy of MRI for intra-articular adhesions was poor; most of the adhesions were not diagnosed by MRI, but intracapsular adhesions could be detected on T2 weighted-images with existing synovial fluid.
我们旨在评估磁共振成像（MRI）在诊断颞下颌关节（TMJ）关节内粘连方面的价值。2003年12月1日至7月31日期间，我们科室连续诊断了27例TMJ内紊乱患者（33个TMJ）。所有患者均接受了MRI和关节镜检查。MRI检查结果记录为“阳性”“可疑”或“阴性”，并与关节镜检查结果进行比较，以得出真阳性、真阴性、假阳性和假阴性结果的数量。关节镜检查证实33个TMJ中有18个存在粘连。MRI显示11个为“阳性”，4个为“可疑”，18个为“阴性”。将这些结果与关节镜检查结果进行比较后，11个“阳性”TMJ中7个为真阳性，4个为假阳性。4个“可疑”TMJ中有3个存在粘连。18个“阴性”TMJ中，10个为真阴性，8个为假阴性。我们得出结论，MRI对关节内粘连的诊断准确性较差；大多数粘连未被MRI诊断出来，但在有滑膜液存在的T2加权图像上可检测到囊内粘连。
