Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Li-Nong Street, Section 2, Taipei, 11221, Taiwan.
Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Road, Taipei, 11217, Taiwan.
Clin Oral Investig. 2019 Oct;23(10):3871-3878. doi: 10.1007/s00784-019-02817-z. Epub 2019 Feb 6.
Magnetic resonance imaging (MRI) is a standardized method for assisting joint diagnosis. To validate the reliability of different imaging-based grading systems, this study examined (1) the associations between grading systems for osseous change, joint effusion, and the Wilkes classification of temporomandibular joint (TMJ) disorders and (2) the correlation between cytokines in synovial fluid and imaging-based joint scores.
Twenty-seven patients, who routinely received numeric rating scale (NRS) and MRI assessment before TMJ arthrocentesis, were enrolled. Each joint was evaluated through the grading criteria for severity of osseous change and joint effusion by blinded observers using MRI. ImageJ was employed for classifying joint effusion. Joint synovial fluid, collected through arthrocentesis, was examined for cytokine expression by using a Luminex multiplex assay. All data were analyzed using the Pearson correlation analysis.
The Wilkes classification was strongly correlated with osseous change scores, but not with joint effusion scores. Joint effusion scores significantly correlated with NRS scores, but not with the Wilkes classification and osseous change scores. Compared with osseous change scores, joint effusion scores had a higher correlation with the levels of inflammatory cytokines (interleukin (IL)-8 and soluble IL-6 receptor (sIL-6R)) and with anti-inflammatory cytokines (soluble tumor necrosis factor receptors I and II (sTNF-RI/II)).
In patients with TMJ disorders, MRI grades are strongly correlated with NRS scores and levels of cytokines (IL-8, sIL-6R, and sTNF-RI/II) in the synovial fluid.
Joint effusion scoring can be a reliable and valid indicator for pathological assessment of TMJ disorders.
磁共振成像（MRI）是一种辅助关节诊断的标准化方法。为了验证基于影像学的不同分级系统的可靠性，本研究检测了（1）骨改变、关节积液和颞下颌关节（TMJ）紊乱Wilkes 分类的分级系统之间的关系，以及（2）滑液中细胞因子与基于影像学的关节评分之间的相关性。
27 例患者在 TMJ 关节穿刺前常规接受数字评分量表（NRS）和 MRI 评估，纳入本研究。每个关节均通过 MRI 由盲法观察者评估骨改变和关节积液的严重程度分级标准进行评估。使用 ImageJ 对关节积液进行分类。通过关节穿刺术收集关节滑液，使用 Luminex 多重分析检测细胞因子表达。所有数据均采用 Pearson 相关分析进行分析。
Wilkes 分类与骨改变评分密切相关，但与关节积液评分无关。关节积液评分与 NRS 评分显著相关，但与 Wilkes 分类和骨改变评分无关。与骨改变评分相比，关节积液评分与炎症细胞因子（白细胞介素（IL）-8 和可溶性白细胞介素 6 受体（sIL-6R））和抗炎细胞因子（可溶性肿瘤坏死因子受体 I 和 II（sTNF-RI/II））水平的相关性更高。
在 TMJ 紊乱患者中，MRI 分级与 NRS 评分和滑液中细胞因子（IL-8、sIL-6R 和 sTNF-RI/II）水平密切相关。
关节积液评分可以作为 TMJ 紊乱病理评估的可靠和有效指标。
