McKay Rachel Marie, Vapniarsky Natalia, Hatcher David, Carr Nicole, Chen Shuai, Verstraete Frank J M, Cissell Derek D, Arzi Boaz
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.
Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.
Front Vet Sci. 2021 Aug 4;8:720641. doi: 10.3389/fvets.2021.720641. eCollection 2021.
Degenerative changes of the temporomandibular joint (DTMJ) may be diagnosed via cone - beam computed tomography (CBCT). However, despite advancement in CBCT imaging, correlation of DTMJ features identified on CBCT with gross and histological findings is currently limited. This study aimed to correlate CBCT findings of DTMJ of dogs with gross and histopathologic changes. Temporomandibular joints (TMJ) ( = 38) from fresh cadaver heads of asymptomatic dogs ( = 19) were examined radiologically, macroscopically, and microscopically. Association of CBCT - detected DTMJ changes with gross and histological findings were statistically evaluated via kappa statistics and ordinal logistic mixed-effects models. The radiological changes observed on CBCT included joint space narrowing, subchondral/cortical bone changes (i.e., erosions or lysis), osteophytes, and subchondral bone sclerosis. Upon macroscopic evaluation, the majority of examined specimens had mild changes with cartilage defects and osteophytes affecting <10% of the total articular surface area. Histopathologic changes comprised splitting and degeneration of the fibrous cartilage layers, subchondral bone exposure, subchondral bone sclerosis, focal subchondral bone lysis, and occasional cell death. Subchondral sclerosis was the most prevalent finding radiologically and histologically with a fair to excellent agreement. Importantly, the more severe the TMJ degenerative changes, the higher the agreement between CBCT and histology. Based on the correlative results of statistical analysis, CBCT was found to be a suitable modality to evaluate DTMJ.
颞下颌关节的退行性改变(DTMJ)可通过锥形束计算机断层扫描(CBCT)进行诊断。然而,尽管CBCT成像技术有所进步,但目前CBCT上识别出的DTMJ特征与大体和组织学发现之间的相关性仍然有限。本研究旨在将犬类DTMJ的CBCT表现与大体和组织病理学变化相关联。对来自无症状犬(n = 19)新鲜尸头的颞下颌关节(TMJ)(n = 38)进行了放射学、大体和显微镜检查。通过kappa统计和有序逻辑混合效应模型对CBCT检测到的DTMJ变化与大体和组织学发现之间的关联进行了统计学评估。CBCT上观察到的放射学变化包括关节间隙变窄、软骨下/皮质骨改变(即侵蚀或溶解)、骨赘和软骨下骨硬化。在大体评估中,大多数检查标本有轻度变化,软骨缺损和骨赘影响的关节表面积不到总面积的10%。组织病理学变化包括纤维软骨层的分裂和退变、软骨下骨暴露、软骨下骨硬化、局灶性软骨下骨溶解以及偶尔的细胞死亡。软骨下硬化是放射学和组织学上最常见的发现,一致性为中等至优秀。重要的是,TMJ退行性改变越严重,CBCT与组织学之间的一致性越高。基于统计分析的相关结果,发现CBCT是评估DTMJ的合适方法。