Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
Dentomaxillofac Radiol. 2010 Sep;39(6):343-8. doi: 10.1259/dmfr/76385066.
the aim of the study was to evaluate the usefulness of cone beam CT (CBCT) in temporomandibular joints (TMJs) with soft tissue pathology.
106 TMJs of 55 patients with temporomandibular disorder (TMD) were examined by MRI and CBCT. MR images were used for the evaluation of disc displacement, disc deformity, joint effusion and obscurity of temporal posterior attachment (TPA). CBCT images were evaluated for the presence or absence of osseous abnormalities. The chi(2) test was used to analyse the association between MRI and CBCT findings.
MRI of 106 TMJs revealed disc displacement, disc deformity, joint effusion and obscurity of the TPA in 68, 73, 28 and 27 joints, respectively. Of the 68 TMJs with disc displacement, anterior disc displacement without reduction (ADDWR) was seen most frequently (47/68). CBCT imaging found 65 TMJs were characterized by the presence of osseous abnormalities and were significantly associated with disc deformity and ADDWR (P < 0.05). There was no statistically significant association between the presence of joint effusion and obscurity of TPA and TMJ osseous abnormalities.
TMD patients with confirmed ADDWR or disc deformity on MRI are at risk of having osseous abnormalities in the TMJ and further examination with CBCT is recommended.
本研究旨在评估锥形束 CT（CBCT）在伴有软组织病变的颞下颌关节（TMJ）中的应用价值。
对 55 例颞下颌关节紊乱病（TMD）患者的 106 个 TMJ 进行 MRI 和 CBCT 检查。MR 图像用于评估盘移位、盘变形、关节积液和颞后附着（TPA）模糊。CBCT 图像用于评估是否存在骨异常。采用卡方检验分析 MRI 和 CBCT 结果之间的相关性。
106 个 TMJ 的 MRI 显示 68 个、73 个、28 个和 27 个关节分别存在盘移位、盘变形、关节积液和 TPA 模糊。在 68 个存在盘移位的 TMJ 中，最常见的是前盘移位无复位（ADDWR）（47/68）。CBCT 成像发现 65 个 TMJ 存在骨异常，与盘变形和 ADDWR 显著相关（P < 0.05）。关节积液和 TPA 模糊的存在与 TMJ 骨异常之间无统计学显著相关性。
MRI 证实存在 ADDWR 或盘变形的 TMD 患者存在 TMJ 骨异常的风险，建议进一步行 CBCT 检查。
