Cakir-Ozkan Nilüfer, Sarikaya Başar, Erkorkmaz Unal, Aktürk Yeliz
Clinic of Oral and Maxillofacial Surgery, Medical Faculty, Gaziosmanpaşa University, Tokat, Turkey.
J Oral Maxillofac Surg. 2010 May;68(5):1075-80. doi: 10.1016/j.joms.2009.08.010. Epub 2010 Mar 1.
We compared high-resolution ultrasonography with magnetic resonance imaging (MRI), as the gold standard, to evaluate lateral and anterior capsule-condyle distances to detect disc displacement of the temporomandibular joint.
This study included 28 patients (19 female and 9 male; age range, 16-51 years; mean age, 32.82 years), and in total, 56 joints were assessed with ultrasonography and MRI. Measurements were obtained for anterior capsule-condyle and lateral capsule-condyle distances in both open- and closed-mouth positions with high-resolution ultrasonography. These findings were also compared with those of MRI taken as reference. Receiver operating characteristic curve analysis was performed to assess our results. We assessed sensitivities, specificities, accuracies, and positive and negative predictive values for both open- and closed-mouth positions.
Diagnostic accuracy of ultrasonographic anterior capsule-condyle distance in the closed-mouth position to detect MRI-positive disc displacement (area under receiver operating characteristic curve, 0.689; P = .015) was the highest.
The measurement of the distance between the most anterior point of the articular capsule and the most anterior point of the condyle can be used to assess disc displacement in diseased joints. However, it is necessary to determine the most accurate threshold value and to set cutoff values. These findings need to be confirmed by further research in a large number of patients to test the interexaminer agreement and the reproducibility of this method.
我们将高分辨率超声检查与作为金标准的磁共振成像(MRI)进行比较,以评估颞下颌关节外侧和前侧关节囊 - 髁突距离,从而检测颞下颌关节盘移位情况。
本研究纳入28例患者(19例女性和9例男性;年龄范围16 - 51岁;平均年龄32.82岁),共对56个关节进行了超声检查和MRI评估。使用高分辨率超声在开口和闭口位测量前侧关节囊 - 髁突及外侧关节囊 - 髁突距离。这些结果还与作为参考的MRI结果进行比较。进行受试者操作特征曲线分析以评估我们的结果。我们评估了开口位和闭口位的敏感性、特异性、准确性以及阳性和阴性预测值。
在闭口位时,超声测量前侧关节囊 - 髁突距离以检测MRI阳性盘移位的诊断准确性最高(受试者操作特征曲线下面积为0.689;P = 0.015)。
测量关节囊最前点与髁突最前点之间的距离可用于评估患病关节的盘移位情况。然而,有必要确定最准确的阈值并设定截断值。这些发现需要通过对大量患者的进一步研究来证实,以检验检查者间的一致性和该方法的可重复性。