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颞下颌关节滑膜软骨瘤病:MRI 表现与病理对照分析。

Synovial chondromatosis of the temporomandibular joint: MRI findings with pathological comparison.

机构信息

Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, China.

出版信息

Dentomaxillofac Radiol. 2012 Feb;41(2):110-6. doi: 10.1259/dmfr/36144602. Epub 2011 Nov 24.

Abstract

OBJECTIVES

The aim of this retrospective study was to characterize MRI findings of synovial chondromatosis in the temporomandibular joint (TMJ) by correlation with their pathological findings.

METHODS

22 patients with synovial chondromatosis in unilateral TMJ were referred for plain MRI prior to surgical management and pathological examinations. Parasagittal and coronal proton density-weighted imaging and T₂ weighted imaging were performed for each case.

RESULTS

MRI demonstrated multiple chondroid nodules and joint effusion in all patients (100%) and amorphous iso-intensity signal tissues within expanded joint space and capsule in 19 patients (86.4%). On T₂ weighted imaging, signs of low signal nodules within amorphous iso-intensity signal tissues were used to determine the presence of attached cartilaginous nodules in pathology, resulting in 100% sensitivity, 60% specificity and 90.9% accuracy. Signs of low and intermediate signal nodules within joint fluids were used to detect loose cartilaginous nodules and resulted in 80% sensitivity, 42.9% specificity and 68.2% accuracy.

CONCLUSIONS

MRI of synovial chondromatosis in TMJ was characterized by multiple chondroid nodules, joint effusion and amorphous iso-intensity signal tissues within the expanded space and capsule. The attached cartilaginous nodules in pathology were better recognized than the loose ones on MRI. Plain MRI was useful for clinical diagnosis of the disorder.

摘要

目的

本回顾性研究旨在通过与病理发现相关联,来描述颞下颌关节(TMJ)滑膜软骨瘤病的 MRI 特征。

方法

22 例单侧 TMJ 滑膜软骨瘤病患者在接受手术治疗和病理检查前接受了常规 MRI 检查。对每个病例均进行了矢状位和冠状位质子密度加权成像和 T₂ 加权成像。

结果

MRI 显示所有患者(100%)均存在多个软骨样结节和关节积液,19 例(86.4%)存在关节间隙和囊状扩张区的等信号强度的不定形组织。在 T₂ 加权成像上,等信号强度不定形组织内低信号结节的存在可用于确定病理附着的软骨结节,其灵敏度为 100%,特异度为 60%,准确率为 90.9%。关节液内低信号和中等信号结节的存在可用于检测游离软骨结节,其灵敏度为 80%,特异度为 42.9%,准确率为 68.2%。

结论

TMJ 滑膜软骨瘤病的 MRI 特征为多个软骨样结节、关节积液和扩张区及囊状的不定形等信号强度组织。与病理上的游离软骨结节相比,MRI 更能识别附着的软骨结节。常规 MRI 有助于该病的临床诊断。

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本文引用的文献

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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Mar;109(3):441-8. doi: 10.1016/j.tripleo.2009.09.036. Epub 2010 Jan 22.
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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Apr;97(4):524-8. doi: 10.1016/j.tripleo.2003.10.027.
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Synovial chondromatosis of the temporomandibular joint extending to temporalis, masticator, and parotid spaces.
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