Department of Orthodontics and Gnathology-Masticatory Function, University of Turin, Turin, Italy.
Int J Prosthodont. 2012 Mar-Apr;25(2):120-6.
The aim of this study was to compare sensitivity differences and interpretative agreement for magnetic resonance imaging (MRI) and computed axiography (CA) tracings in a patient population group with temporomandibular disorder (TMD).
A convenience sample of 173 patients (53 men, 120 women; mean age: 33.2 ± 2.6 years) diagnosed with TMD was selected for this study. Each patient underwent an evaluation as per the European Academy of Craniomandibular Disorders clinical form as well as MRI and CA.
Use of the MRI results as the gold standard for the planned comparison led to the following observations: a CA sensitivity of 68% for joints without morphologic changes (so-called normal temporomandibular joints [TMJs]), sensitivity of 27% for those with disc displacement, and sensitivity of 8% for those with osteoarthritis. The kappa index, or agreement between the two examination methods, was weak for normal TMJs (0.16), acceptable for anterior disc displacement with reduction (0.28), little for anterior disc displacement without reduction (0.10), and very little for morphologic alterations (0.01).
The sensitivity and agreement of the two examination methods was generally low. It was even worse when pathologic changes in the TMJ were more severe. MRI and CA are different examinations that could both be considered for severe TMD diagnosis.
本研究旨在比较磁共振成像（MRI）和计算机轴向成像（CA）描记在患有颞下颌关节紊乱（TMD）的患者群体中的敏感性差异和解释一致性。
本研究选择了 173 名 TMD 患者（53 名男性，120 名女性；平均年龄：33.2±2.6 岁）作为便利样本。每位患者均根据欧洲颅面疼痛协会的临床表格以及 MRI 和 CA 进行评估。
将 MRI 结果用作计划比较的金标准，得出以下观察结果：无形态变化（所谓的正常颞下颌关节[TMJ]）的 CA 敏感性为 68%，有盘移位的敏感性为 27%，有骨关节炎的敏感性为 8%。两种检查方法之间的kappa 指数（或一致性）对于正常 TMJ 较弱（0.16），对于可复性前盘移位可接受（0.28），对于不可复性前盘移位较小（0.10），对于形态改变非常小（0.01）。
两种检查方法的敏感性和一致性通常较低。TMJ 病理变化更严重时，情况更糟。MRI 和 CA 是两种不同的检查方法，均可用于严重 TMD 的诊断。
