Rao V M, Farole A, Karasick D
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Radiology. 1990 Mar;174(3 Pt 1):663-7. doi: 10.1148/radiology.174.3.2305046.
This prospective study correlated the results of magnetic resonance (MR) imaging, arthrography, and arthroscopy in 27 patients with clinically suspected temporomandibular joint (TMJ) dysfunction. Open surgical confirmation was available in 12 TMJs. The variables assessed with each modality were disk position and morphology, disk perforation, joint adhesions, and degenerative joint disease. MR imaging was superior to dual joint arthrography with arthrotomography in delineation of the disk position. MR imaging accurately demonstrated the disk position in 11 joints (92%); arthrography was accurate in nine of the 12 joints (75%) with surgically confirmed dysfunction. Disk perforations and joint adhesions were not demonstrated with MR imaging. Arthroscopy was superior to arthrography and MR imaging in the detection of disk perforations, joint adhesions, and early degenerative changes along the articular eminence and glenoid fossa. The authors believe MR imaging should constitute the first line of imaging because it provides accurate information about disk position in a noninvasive manner. In most cases, information obtained with MR imaging is adequate in deciding whether to institute conservative or surgical management; in difficult cases, triple correlation may be needed.
这项前瞻性研究对27例临床怀疑有颞下颌关节（TMJ）功能障碍患者的磁共振（MR）成像、关节造影和关节镜检查结果进行了相关性分析。12个颞下颌关节有开放手术确诊结果。每种检查方式评估的变量包括盘状结构位置和形态、盘状结构穿孔、关节粘连以及关节退行性疾病。在确定盘状结构位置方面，MR成像优于双重关节造影加关节断层摄影。MR成像在11个关节（92%）中准确显示了盘状结构位置；在12个经手术确诊功能障碍的关节中，关节造影在9个关节（75%）中显示准确。MR成像未显示盘状结构穿孔和关节粘连。在检测盘状结构穿孔、关节粘连以及关节结节和关节盂早期退行性改变方面，关节镜检查优于关节造影和MR成像。作者认为MR成像应作为首选的成像检查方式，因为它能以非侵入性方式提供有关盘状结构位置的准确信息。在大多数情况下，MR成像获得的信息足以决定是采取保守治疗还是手术治疗；在疑难病例中，可能需要三种检查方式相互关联。
