Eckstein Fabian Matthias, Wurm Matthias Christian, Eckstein Markus, Wiesmüller Marco, Müller Magdalena, Jehn Philipp, Söder Stephan, Schlittenbauer Tilo
Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen Nuremberg, Glückstraße 11, 91054 Erlangen, Germany; Department of Oral and Maxillofacial Surgery, Hannover Medical School Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen Nuremberg, Glückstraße 11, 91054 Erlangen, Germany.
J Stomatol Oral Maxillofac Surg. 2022 Jun;123(3):353-357. doi: 10.1016/j.jormas.2021.05.002. Epub 2021 May 12.
The gold standard for temporomandibular joint imaging is magnetic resonance imaging, although there are still pathological findings that cannot be seen in MRI but in surgery and the subsequent histological analysis only. The main goal of this investigation was to validate the MRI score used by histopathological findings as well as clinical findings. In this retrospective study 39 patients were included; 38 of which underwent unilateral and 1 underwent bilateral discectomy. MRI findings were graded according to the score by Wurm. Histopathological analysis was performed in hematoxylin-eosin staining and graded in accordance with the scores by Krenn and by Leonardi. For valuation of preoperative pain values of the temporomandibular joint operated on the numeric rating scale was utilized. Correlations were verified by Spearman-Rho. The MRI scores on average showed significantly lower scores for the discs of the operated temporomandibular joint than for the discs of the non-operated side(p<.01). No significant correlations between MRI findings, histopathological findings and pain intensities could be observed. Thus unsuspicious morphology of the TMJ and the articular disc in MRI is no guarantee for the absence of cartilage-degeneration. Further investigations utilizing T2 cartilage mapping could possibly show better correlations between the temporomandibular joint's degree of degeneration and imaging results.
颞下颌关节成像的金标准是磁共振成像，尽管仍有一些病理发现仅在手术及后续组织学分析中可见，而在磁共振成像中无法看到。本研究的主要目的是验证基于组织病理学发现以及临床发现所使用的磁共振成像评分。在这项回顾性研究中，纳入了39例患者；其中38例接受了单侧椎间盘切除术，1例接受了双侧椎间盘切除术。磁共振成像结果根据Wurm的评分进行分级。组织病理学分析采用苏木精-伊红染色，并根据Krenn和Leonardi的评分进行分级。采用数字评分量表对接受手术的颞下颌关节术前疼痛值进行评估。相关性通过Spearman-Rho检验进行验证。平均而言，接受手术的颞下颌关节椎间盘的磁共振成像评分显著低于未手术侧的椎间盘评分（p<0.01）。未观察到磁共振成像结果、组织病理学结果与疼痛强度之间存在显著相关性。因此，磁共振成像中颞下颌关节和关节盘形态无异常并不能保证不存在软骨退变。利用T2软骨成像的进一步研究可能会显示颞下颌关节退变程度与成像结果之间有更好的相关性。
