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颞下颌关节紊乱患者 1717 例头部和颈部 MRI 筛查中的偶然发现。

Incidental findings during head and neck MRI screening in 1717 patients with temporomandibular disorders.

机构信息

Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan.

出版信息

Oral Radiol. 2019 May;35(2):135-142. doi: 10.1007/s11282-018-0327-y. Epub 2018 Apr 3.

Abstract

OBJECTIVE

Magnetic resonance imaging (MRI) plays an important role in the evaluation of temporomandibular disorders (TMDs). At our institution, we perform additional head and neck screening using head coils when performing MRI screening of the temporomandibular joint (TMJ) to detect lesions in areas other than the TMJ (lesions discovered by chance, or incidental findings; IFs) and to conduct a diagnosis of exclusion. The objective of this study was to determine the number and frequency of IFs detected during head and neck screening, according to sites and diseases.

MATERIALS AND METHODS

The study evaluated 1717 patients with clinically suspected TMDs who underwent MRI of the TMJ. IFs were assessed on horizontal sections of images of the craniofacial region obtained by the short tau inversion recovery imaging technique.

RESULTS

The patients undergoing MRI of the TMJ comprised 433 males and 1284 females. Among the patients, at least one IF was detected on images in 461 patients. The most common IF site was the maxillary sinus. Based on diagnostic imaging, there were 21 IFs (1.2%) associated with TMD symptoms, or for which an association with TMD symptoms could not be ruled out.

CONCLUSIONS

Combination of conventional MRI imaging of the TMJ with craniofacial MRI screening may allow detection of lesions other than TMDs, thereby confirming the usefulness of MRI. Detection of IFs may require development of different therapeutic strategies than those for TMDs.

摘要

目的

磁共振成像(MRI)在颞下颌关节紊乱(TMD)的评估中发挥着重要作用。在我们机构,当对颞下颌关节(TMJ)进行 MRI 筛查时,我们会使用头线圈对头部和颈部进行额外的筛查,以检测 TMJ 以外区域的病变(偶然发现的病变或偶然发现的病变;IFs),并进行排除性诊断。本研究的目的是根据部位和疾病确定在头颈部筛查中检测到的 IFs 的数量和频率。

材料和方法

本研究评估了 1717 例临床疑似 TMD 患者,这些患者均接受了 TMJ 的 MRI 检查。通过短反转时间反转恢复成像技术获得的头面部区域水平切片图像评估 IFs。

结果

接受 TMJ MRI 检查的患者中,男性 433 例,女性 1284 例。在这些患者中,至少有 1 例患者在图像上检测到 IF。最常见的 IF 部位是上颌窦。根据诊断性影像学检查,有 21 例 IF(1.2%)与 TMD 症状相关,或不能排除与 TMD 症状的关联。

结论

TMJ 的常规 MRI 成像与头面部 MRI 筛查相结合,可能会发现 TMD 以外的病变,从而证实 MRI 的有用性。IFs 的检测可能需要制定与 TMD 不同的治疗策略。

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