Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy.
J Oral Rehabil. 2023 Oct;50(10):1082-1092. doi: 10.1111/joor.13529. Epub 2023 Jun 23.
The objectives of this systematic review were to evaluate the correlation between Ultrasound (US) and Magnetic Resonance Imaging (MRI) in patients with JIA and to investigate the association with Temporomandibular Disorders (TMD).
The protocol was registered in PROSPERO (CRD42022312734). Databases Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature were searched. Eligibility criteria were patients with JIA subjected to diagnostic evaluation using US and MRI. No language restrictions were applied. After duplicate study selection, data extraction and risk of bias assessment according to Cochrane were conducted. Data extraction of patients was conducted by two independent authors.
Five observational studies were included with 217 participants (153 females and 64 males; mean age 11.3 years). The quality of the studies was overall satisfactory. The correlation between US and MRI in children with JIA was 'moderate' in acute arthritis while the chronic arthritis correlated positively in two studies.
Even if MRI remains the more accurate imaging modality for the detection of TMJ of patients with JIA, US may be useful to early detect pathological conditions and to address the patient with JIA and putative TMJ involvement to a more accurate diagnosis with MRI and consequent appropriate treatment management.
MRI should be deemed necessary only secondary to less-invasive assessments with US just to confirm the diagnosis or to increase sensitivity, accuracy of positive predictive values detected.
本系统评价的目的是评估幼年特发性关节炎(JIA)患者的超声(US)与磁共振成像(MRI)之间的相关性,并探讨与颞下颌关节紊乱(TMD)的关联。
该方案已在 PROSPERO(CRD42022312734)中注册。检索了 Medline、Embase、Cochrane 对照试验中心注册库、Scopus、Web of Science、拉丁美洲和加勒比健康科学文献数据库。纳入标准为接受 US 和 MRI 诊断评估的 JIA 患者。未应用语言限制。经过重复研究选择、数据提取和按照 Cochrane 进行的偏倚风险评估后,由两名独立作者进行患者数据提取。
共纳入 5 项观察性研究,共 217 名参与者(153 名女性和 64 名男性;平均年龄 11.3 岁)。研究的整体质量令人满意。JIA 儿童的急性关节炎中 US 和 MRI 之间的相关性为“中度”,而在两项研究中慢性关节炎呈正相关。
尽管 MRI 仍然是检测 JIA 患者 TMJ 的更准确成像方式,但 US 可能有助于早期发现病理状况,并将患有 JIA 和可能存在 TMJ 受累的患者转介至 MRI 进行更准确的诊断,从而进行相应的治疗管理。
仅在 US 等非侵入性评估之后,认为有必要进行 MRI,以确认诊断或提高检测到的阳性预测值的敏感性和准确性。