磁共振成像对退行性颞下颌关节疾病的诊断性能。

Diagnostic performance of magnetic resonance imaging for degenerative temporomandibular joint disease.

机构信息

Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China.

出版信息

J Oral Rehabil. 2023 Jan;50(1):24-30. doi: 10.1111/joor.13386. Epub 2022 Nov 9.

DOI:10.1111/joor.13386

PMID:36288407

Abstract

BACKGROUND

Degenerative joint disease (DJD) of the temporomandibular joint (TMJ) is an important type of temporomandibular disorders (TMDs) potentially leading to orofacial pain and jaw dysfunction. Magnetic resonance imaging (MRI) is important in TMD diagnosis; however, its diagnostic ability for DJD remains unknown.

OBJECTIVE

To explore the utility of MRI in diagnosing DJD according to the latest diagnostic criteria for TMD and detecting condylar bone abnormalities and their severity.

METHODS

Overall, 122 participants were examined using cone-beam computed tomography (CBCT) and MRI. The sensitivity, specificity and accuracy of MRI for detecting DJD and different types of TMJ condylar bone abnormalities were calculated (considering CBCT as gold standard); in addition, we tested MRI and CBCT's consistency in scoring five types of condylar bone abnormalities.

RESULTS

The sensitivity and specificity of MRI for DJD were 95.3% and 43.1%, respectively. The MRI sensitivities for condylar flattening, erosion, osteophytes, sclerosis and cysts were 98.6%, 96.2%, 79.4%, 50%, and 79.2% (specificity, 53.6%, 48.3%, 81.6%, 83.3%, and 88.2%, respectively), respectively. The consistency between MRI and CBCT in assessing the severity of condylar bone abnormalities was fair-to-moderate (kappa coefficient: 0.278-0.491). The inter-observer consistency for CBCT was good, whereas for MRI, it was relatively poor.

CONCLUSION

MRI can detect DJD and condylar bone abnormalities. However, MRI could not efficiently detect the severity of condylar bone abnormalities.

摘要

背景

颞下颌关节（TMJ）退行性关节病（DJD）是一种重要的颞下颌关节紊乱（TMD）类型，可能导致口颌疼痛和下颌功能障碍。磁共振成像（MRI）在 TMD 诊断中很重要；然而，其对 DJD 的诊断能力尚不清楚。

目的

根据最新的 TMD 诊断标准，探讨 MRI 诊断 DJD 以及检测髁突骨异常及其严重程度的能力。

方法

共对 122 名参与者进行了锥形束计算机断层扫描（CBCT）和 MRI 检查。计算了 MRI 诊断 DJD 和不同类型 TMJ 髁突骨异常的灵敏度、特异性和准确性（以 CBCT 为金标准）；此外，我们还测试了 MRI 和 CBCT 在评估五种类型髁突骨异常方面的一致性。

结果

MRI 诊断 DJD 的灵敏度和特异性分别为 95.3%和 43.1%。MRI 对髁突变平、侵蚀、骨赘、硬化和囊肿的灵敏度分别为 98.6%、96.2%、79.4%、50%和 79.2%（特异性分别为 53.6%、48.3%、81.6%、83.3%和 88.2%）。MRI 和 CBCT 在评估髁突骨异常严重程度方面的一致性为中等至良好（kappa 系数：0.278-0.491）。CBCT 的观察者间一致性良好，而 MRI 的观察者间一致性较差。