Kang J-H, An Y-S, Park S-H, Song S I
Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Gyeonggi-do, Republic of Korea.
Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, Suwon, Gyeonggi-do, Republic of Korea.
Int J Oral Maxillofac Surg. 2018 Nov;47(11):1445-1452. doi: 10.1016/j.ijom.2018.05.011. Epub 2018 May 31.
Bone scintigraphy has been used for the diagnosis of early-stage temporomandibular joint (TMJ) osteoarthritis (OA) owing to its high sensitivity. However, the diagnostic value of bone scintigraphy may be compromised when applied to patients in an age range with high bone metabolism rates. The aim of this study was to investigate the validity of bone scintigraphy as an appropriate diagnostic modality for TMJ OA. A total of 406 subjects (145 male, 261 female; age range 14-87 years) were selected, and all subjects underwent both bone scintigraphy and computed tomography (CT). The diagnosis of TMJ OA was confirmed with CT. Images obtained with bone scintigraphy were analyzed by visual and quantitative methods using the TMJ-to-skull ratio. The TMJ-to-skull ratio was significantly higher during adolescence and elderly adulthood, but differences between the sexes were not significant. The diagnostic value of the TMJ-to-skull ratio was lower in elderly adulthood in both males and females. The diagnostic utility of visual assessment was also compromised during late adulthood in both males and females. Thus bone scintigraphy has little value in the detection of TMJ OA, because the results could be influenced by age-related bone metabolism rates.
由于骨闪烁显像具有高敏感性，它已被用于颞下颌关节（TMJ）早期骨关节炎（OA）的诊断。然而，当应用于骨代谢率高的年龄段患者时，骨闪烁显像的诊断价值可能会受到影响。本研究的目的是探讨骨闪烁显像作为TMJ OA合适诊断方式的有效性。共选取了406名受试者（男性145名，女性261名；年龄范围14 - 87岁），所有受试者均接受了骨闪烁显像和计算机断层扫描（CT）。TMJ OA的诊断通过CT得以证实。利用TMJ与颅骨的比值，通过视觉和定量方法对骨闪烁显像获得的图像进行分析。TMJ与颅骨的比值在青春期和老年期显著更高，但性别之间的差异不显著。在老年期，男性和女性的TMJ与颅骨比值的诊断价值均较低。在成年晚期，男性和女性的视觉评估诊断效用也受到影响。因此，骨闪烁显像在检测TMJ OA方面价值不大，因为结果可能会受到与年龄相关的骨代谢率的影响。
