Gómez Marcos, Rodríguez Brigitte, Hernández-Andara Adalsa, Ortega-Pertuz Ana I
Unidad Holos. Miranda, Venezuela.
Hospital General del Oeste Dr. José Gregorio Hernández. Caracas, Venezuela.
Rev Cient Odontol (Lima). 2024 Mar 30;12(1):e190. doi: 10.21142/2523-2754-1201-2024-190. eCollection 2024 Jan-Mar.
Partial or total perforation of the articular disc is mainly observed in the final stage of temporomandibular disorder. Magnetic resonance imaging (MRI) is considered the gold standard for the diagnosis of joint pathologies; MRI arthrography consists of the infiltration of a contrast medium into a joint, being Gadolinium chelates the most employed medium, however, possible harmful effects have been associated with its use. The aim of this work was to evaluate a case of perforation of the articular disc of the temporomandibular joint by MRI arthrography using physiological solution (NaCl 0.9%) as contrast medium. MR images were obtained with a STIR (Short Tau Inversion Recovery) weighted pulse sequence in the sagittal and coronal planes at maximum mouth opening, after the injection of the physiological solution in the superior articular space. The communication of both articular spaces was identified, observing a greater filling in the inferior articular space, as well as the latero-medial displacement of the disc segments. Arthrography with physiological solution allowed the precise diagnosis of the perforation, which made it possible to guide the treatment plan, reducing diagnostic and surgical times, also considering the reduction of complications and adverse effects related to other contrast media, added to the benefit of the reduction of the cost of the exam.
关节盘部分或完全穿孔主要见于颞下颌关节紊乱病的终末期。磁共振成像（MRI）被认为是诊断关节病变的金标准；MRI关节造影是将造影剂注入关节，钆螯合物是最常用的造影剂，然而，其使用可能会带来有害影响。本研究的目的是通过使用生理盐水（0.9%氯化钠）作为造影剂的MRI关节造影来评估一例颞下颌关节盘穿孔病例。在将生理盐水注入上关节腔后，于最大张口位在矢状面和冠状面采用短Tau反转恢复（STIR）加权脉冲序列获取MR图像。发现两个关节腔相通，下关节腔充盈更多，同时关节盘各段有内外侧移位。生理盐水关节造影能够精确诊断穿孔，从而指导治疗方案，减少诊断和手术时间，还能减少与其他造影剂相关的并发症和不良反应，此外还能降低检查成本。
