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利用磁共振成像观察人体颞下颌关节中自体游离脂肪移植的转归

The fate of autogenous free fat grafts in the human temporomandibular joint using magnetic resonance imaging.

作者信息

Shen Pei, Sun Qi, Xu Weifeng, Zhen Jinze, Zhang Shanyong, Yang Chi

机构信息

Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.

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

出版信息

J Craniomaxillofac Surg. 2015 Nov;43(9):1804-8. doi: 10.1016/j.jcms.2015.08.024. Epub 2015 Sep 8.

Abstract

OBJECTIVE

Autologous fat grafts in the temporomandibular joint (TMJ) has achieved positive clinical effects in preventing adhesion after surgery. However it still remains indeterminate about the survival rate of grafted fat. The purpose of this study was to evaluate the long-term survival rate of free fat grafts in the TMJ using magnetic resonance imaging (MRI).

MATERIALS AND METHODS

89 patients (117 joints) with free fat grafts placed into TMJs following modified TMJ disc anchor were included in our study. They were divided into the following groups according to the time lapse between TMJ surgery and the latest MRI investigation: 1-3 months, 4-6 months, 7-12 months, 13-24 months, and >24 months. The signal intensity changes and volume retention were evaluated by MRI.

RESULTS

The volume retention rate of grafted free fat showed that the size was hovering right around 50% although it reduced very slowly with a long-term follow-up. Nearly half joints showed lower signal intensity of the grafted fat on MRI within 6 months and it recovered to normal compared with that of the day after surgery 6 months later.

CONCLUSIONS

Free fat grafted into TMJ cavity could be alive for a long time with the survival rate about 48.44%. However the survival mechanism has still been unknown, which need us to explore and study in the future.

摘要

目的

颞下颌关节(TMJ)自体脂肪移植在预防术后粘连方面已取得了积极的临床效果。然而,移植脂肪的存活率仍不明确。本研究的目的是使用磁共振成像(MRI)评估TMJ游离脂肪移植的长期存活率。

材料与方法

本研究纳入了89例(117个关节)在改良TMJ盘锚固术后将游离脂肪移植到TMJ的患者。根据TMJ手术与最新MRI检查之间的时间间隔,将他们分为以下几组:1 - 3个月、4 - 6个月、7 - 12个月、13 - 24个月和>24个月。通过MRI评估信号强度变化和体积保留情况。

结果

移植游离脂肪的体积保留率显示,尽管经过长期随访其体积下降非常缓慢,但大小仍徘徊在50%左右。近一半的关节在6个月内MRI上显示移植脂肪信号强度较低,6个月后与术后第一天相比恢复正常。

结论

移植到TMJ腔的游离脂肪可以长期存活,存活率约为48.44%。然而,其存活机制仍然未知,这需要我们在未来进行探索和研究。

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