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[颞下颌关节盘移位患者髁突位置及形态的MRI观察]

[MRI observation of condylar location and morphology in the patients with temporomandibular disc displacement].

作者信息

Fan W P, Liu M Q, Zhang X H, Chen Z Y

机构信息

Department of Radiology, Hainan Hospital of General Hospital of Chinese PLA, Sanya 572013, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2019 Aug 9;54(8):522-526. doi: 10.3760/cma.j.issn.1002-0098.2019.08.004.

Abstract

To evaluate the mandibular condylar location and morphology in the temporomandibular joint disorders. One hundred thirty-seven TMD patients (age 37.5±16.1 years, male/female=39/98) were performed with MRI scan for temporomandibular joint (TMJ) from November, 2011 to April, 2019 in Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA and General Hospital of Chinese PLA. The patients were classified into 3 groups according the disc displacement: disc without displacement (DWoD) (185 TMJ), disc displacement with reduction (DDWR) (17 TMJ) and disc displacement without reduction (DDWoR) (72 TMJ). The location (anterior position, central position and posterior position) and morphology (oval shape, flat shape and beaklike shape) of the condylar head were observed on the sagittal PDWI, and the long and short axes were measured on the axial T2WI. Another groups were classified into 3 subgroups according to the disc displacement of bilateral TMJ: bilateral normal disc location (biND) (74 cases), unilateral disc displacement (uniDD) (40 cases) and bilateral disc displacement (23 cases). The inter-condyle angle was measured on the axial T2WI. There was no significant difference for the location of condylar head among DWoD, DDWR and DDwoR groups (χ(2)=7.435, 0.115). The rate for flat condylar shape was significantly higher in DWoD group [83.9%(115/137)] than that in DDWoR group [50.7%(34/67)], and the rate for beaklike condylar shape was significantly lower in DWoD group [16.1%(22/137)] than that in DDWoR group [49.3%(33/67)] (χ(2)=23.521, 0.001). The length of long axis presented significantly longer in DWoD group [(17.2±2.4) mm] than that in DDWR group [(15.4±2.0) mm] and that in DDWoR group [(14.7±2.7) mm] (0.05). The length of short axis presented significantly longer in DWoD group [(7.3±1.2) mm] than that in DDWR group [(6.5±1.3) mm] and that in DDWoR group [(6.1±1.4) mm] (0.05). The inter-condyle angle presented significantly larger in biND group (136°±13°) and uniDD group (132°±14°) than that inbiDD group (124°±17°) (0.05). The mandibular condylar morphology changes significantly presented in the patients with temporomandibular disc displacement for the temporomandibular disorders.

摘要

评估颞下颌关节紊乱病中下颌髁突的位置和形态。2011年11月至2019年4月,在中国人民解放军总医院海南医院放射科和中国人民解放军总医院,对137例颞下颌关节紊乱病患者(年龄37.5±16.1岁,男/女=39/98)进行了颞下颌关节(TMJ)的MRI扫描。根据盘移位情况将患者分为3组:无盘移位(DWoD)(185个TMJ)、可复性盘移位(DDWR)(17个TMJ)和不可复性盘移位(DDWoR)(72个TMJ)。在矢状面质子密度加权成像(PDWI)上观察髁突头部的位置(前位、中位和后位)和形态(椭圆形、扁平形和喙状形),并在轴位T2加权成像(T2WI)上测量长轴和短轴。另一组根据双侧TMJ的盘移位情况分为3个亚组:双侧盘位置正常(biND)(74例)、单侧盘移位(uniDD)(40例)和双侧盘移位(23例)。在轴位T2WI上测量髁间角。DWoD、DDWR和DDWoR组之间髁突头部的位置无显著差异(χ(2)=7.435,P=0.115)。DWoD组扁平髁突形态的发生率[83.9%(115/137)]显著高于DDWoR组[50.7%(34/67)],DWoD组喙状髁突形态的发生率[16.1%(22/137)]显著低于DDWoR组[49.3%(33/67)](χ(2)=23.521,P=0.001)。DWoD组的长轴长度[(17.2±2.4)mm]显著长于DDWR组[(15.4±2.0)mm]和DDWoR组[(14.7±2.7)mm](P<0.05)。DWoD组的短轴长度[(7.3±1.2)mm]显著长于DDWR组[(6.5±1.3)mm]和DDWoR组[(6.1±1.4)mm](P<0.05)。biND组(136°±13°)和uniDD组(132°±14°)的髁间角显著大于biDD组(124°±17°)(P<0.05)。颞下颌关节紊乱病患者中,颞下颌盘移位时下颌髁突形态变化显著。

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