Department of Functional Masticatory Disorders, Medical University of Lublin, Karmelicka 7 Street, 20-081, Lublin, Poland.
Department of Dental and Maxillofacial Radiology, Medical University of Lublin, Karmelicka 7 Street, 20-081, Lublin, Poland.
Clin Oral Investig. 2021 Jan;25(1):159-168. doi: 10.1007/s00784-020-03347-9. Epub 2020 Jun 17.
The aim of this study was to evaluate diagnoses of temporomandibular (TMJ) disc displacement by comparing evaluations done on the basis of central sagittal scans only, the most often used in temporomandibular disorder (TMD) patients, with a multisection evaluation done with both sagittal and coronal scans.
Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to RDC/TMD criteria. Disc position in the intercuspal position (IP) was assessed two times using two different methods. The first method involved a TMJ disc position evaluation on the central slide in the oblique sagittal plane only. In the second method, the TMJ disc position was assessed on all oblique sagittal and coronal images. McNemar's χ test was used to evaluate the differences between the sensitivities of two methods.
The first method (central oblique sagittal scans assessment) identified 148 TMJs (38.7%) with normal disc position compared with 89 TMJs (23.3%) with normal disc position found by the second method (all oblique sagittal and coronal scans assessment). The sensitivity of analysis in both planes was significantly higher than in the sagittal plane only (p < 0.001).
The multisection analysis in the sagittal and coronal plane allows to distinguish the correct disc position from disc displacement and thus improve evaluation of TMJ internal derangement.
The multisection sagittal and coronal images should be recommended as a standard in MRI of the TMJ disc displacement in patients with TMD to avoid false-negative diagnoses.
本研究旨在通过比较仅基于正中矢状位扫描(最常用于颞下颌关节紊乱病(TMD)患者)评估与使用矢状位和冠状位扫描进行多节段评估,评估颞下颌(TMJ)关节盘移位的诊断。
对 191 例符合 RDC/TMD 标准的关节盘移位患者的 382 个 TMJ 进行多节段 MRI 分析。采用两种不同方法两次评估髁突在正中位(IP)时的位置。第一种方法仅在斜矢状位的中央幻灯片上评估 TMJ 关节盘位置。在第二种方法中,评估所有斜矢状位和冠状位图像上的 TMJ 关节盘位置。采用 McNemar's χ 检验评估两种方法的敏感性差异。
第一种方法(仅评估正中斜矢状位扫描)与第二种方法(评估所有斜矢状位和冠状位扫描)相比,确定 148 个 TMJ(38.7%)的关节盘位置正常,而确定 89 个 TMJ(23.3%)的关节盘位置正常。两种平面的分析敏感性明显高于仅矢状位分析(p<0.001)。
矢状位和冠状位的多节段分析可以区分正确的关节盘位置和关节盘移位,从而改善 TMJ 内部紊乱的评估。
建议将矢状位和冠状位多节段图像作为 TMD 患者 TMJ 关节盘移位 MRI 的标准,以避免假阴性诊断。