Westesson P L, Katzberg R W, Tallents R H, Sanchez-Woodworth R E, Svensson S A
AJR Am J Roentgenol. 1987 Jun;148(6):1165-71. doi: 10.2214/ajr.148.6.1165.
CT and MR imaging have been advocated for use in the diagnosis of disorders of the temporomandibular joint. A systematic comparison of these imaging techniques has not been made. We performed direct sagittal CT and sagittal MR on 15 fresh temporomandibular joint autopsy specimens and compared our diagnoses with cryosectional findings in a blinded fashion. We found no statistically significant differences between these procedures in detecting bony abnormalities or disk position. However, a side-by-side comparison between the CT and MR images demonstrated that MR depicted the soft-tissue anatomy of the joint with greater detail than did CT. Thus, MR clearly displayed the disk when it was positioned either superiorly or anteriorly, whereas CT only showed the disk adequately when it was positioned anteriorly. MR further showed the configuration of the disk and the borderlines between the disk and its attachments; these relationships could not be assessed from CT images. This experimental study indicates that MR is superior to CT for depiction of soft-tissue changes, whereas CT is superior in showing osseous abnormalities. Clinical confirmation of these results is necessary before one method can be definitively recommended over the other for clinical studies.
CT和MR成像已被提倡用于颞下颌关节疾病的诊断。尚未对这些成像技术进行系统比较。我们对15个新鲜颞下颌关节尸检标本进行了直接矢状面CT和矢状面MR检查，并以盲法将我们的诊断结果与冷冻切片结果进行比较。我们发现在检测骨质异常或盘状位置方面，这些检查方法之间没有统计学上的显著差异。然而，CT和MR图像的并排比较表明，MR比CT更能详细显示关节的软组织解剖结构。因此，当盘状结构位于上方或前方时，MR能清晰显示，而CT只有在盘状结构位于前方时才能充分显示。MR还显示了盘状结构的形态及其与附着结构之间的边界线；这些关系无法从CT图像中评估。这项实验研究表明，在显示软组织变化方面，MR优于CT，而在显示骨质异常方面，CT更具优势。在临床研究中明确推荐一种方法优于另一种方法之前，有必要对这些结果进行临床验证。
