Department of Radiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, China.
Department of Neurology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2020 Mar 5;133(5):530-536. doi: 10.1097/CM9.0000000000000658.
Texture features were the intrinsic properties of the human tissues and could efficiently detect the subtle functional changes of involved tissue. The pathologic changes of the lateral pterygoid muscle (LPM) were significantly correlated with the temporomandibular disc displacement. However, the occult functional changes of LPM could not be detected by the naked eye on the medical images. The current study was aimed to evaluate the functional changes of the LPM in the patients with temporomandibular disorders (TMDs) using texture analysis.
Twenty-nine patients with TMD were performed with magnetic resonance (MR) imaging on a 3.0T MR scanner, who were consecutively recruited from the TMD clinic of Hainan Hospital of Chinese People's Liberation Army General Hospital from February 2019 to September 2019. The patients were classified into three groups according to the disc displacement: disc without displacement (DWoD), disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR). The gray-level co-occurrence matrix method was applied with the texture analysis of LPM on the axial T2-weighted imaging. The texture features included angular second moment, contrast, correlation, inverse different moment, and entropy. One-way analysis of variance was used for grouped comparisons and receiver operating characteristics (ROC) curve analysis was applied to evaluate the diagnostic efficacy of the texture parameters.
Texture contrast of LPM presented significantly lower in DDWoR (46.30 [35.03, 94.48]) than that in DWoD (123.85 [105.06, 143.23]; test statistic = 23.05; P < 0.001). Texture entropy of LPM showed significant differences among DWoD (7.62 ± 0.33), DDWR (6.76 ± 0.35), and DDWoR (6.46 ± 0.39) (PDWoD-DDWR < 0.001, PDWoD-DDWoR < 0.001, and PDDWR-DDWoR = 0.014). Area under the ROC curve (AUC) demonstrated that texture entropy had an excellent diagnostic accuracy for DWoD-DDWR (AUC = 0.96) and DWoD-DDWoR (AUC = 0.98).
The texture contrast and entropy could identify the altered functional status of LPM in patients with TMD and could be considered as the effective imaging biomarker to evaluate the functional changes of LPM in TMD.
纹理特征是人体组织的固有属性，能够有效地检测到受累组织的细微功能变化。翼外肌（LPM）的病理变化与颞下颌关节盘移位有明显的相关性。然而，在医学图像上肉眼无法观察到 LPM 的隐匿性功能变化。本研究旨在使用纹理分析评估颞下颌关节紊乱（TMD）患者 LPM 的功能变化。
2019 年 2 月至 2019 年 9 月，连续从中国人民解放军总医院海南医院 TMD 诊所招募 29 例 TMD 患者，在 3.0T 磁共振成像仪上进行磁共振成像（MR）检查。根据盘位移情况将患者分为三组：无盘位移（DWoD）、盘有位移但可复位（DDWR）和盘有位移但不可复位（DDWoR）。采用灰度共生矩阵方法对 LPM 的轴向 T2 加权成像进行纹理分析。纹理特征包括角二阶矩、对比度、相关性、逆差矩和熵。采用单因素方差分析进行组间比较，应用受试者工作特征（ROC）曲线分析评估纹理参数的诊断效能。
DDWoR 组 LPM 的纹理对比度明显低于 DWoD 组（46.30[35.03,94.48]比 123.85[105.06,143.23]；检验统计量=23.05；P<0.001）。DWoD、DDWR 和 DDWoR 三组间 LPM 纹理熵差异有统计学意义（7.62±0.33、6.76±0.35、6.46±0.39）（PDWoD-DDWR<0.001，PDWoD-DDWoR<0.001，PDDWR-DDWoR=0.014）。ROC 曲线下面积（AUC）表明，纹理熵对 DWoD-DDWR（AUC=0.96）和 DWoD-DDWoR（AUC=0.98）具有良好的诊断准确性。
纹理对比度和熵可识别 TMD 患者 LPM 功能状态的改变，可作为评估 TMD 中 LPM 功能变化的有效影像学生物标志物。
