Watt-Smith S, Sadler A, Baddeley H, Renton P
John Radcliffe Hospital, Oxford.
Br J Oral Maxillofac Surg. 1993 Jun;31(3):139-43. doi: 10.1016/0266-4356(93)90111-9.
Arthrotomography and magnetic resonance imaging (MRI) were carried out on 50 temporomandibular joints (TMJs) in 48 patients who were being considered for surgery for clinically diagnosed internal derangement. The patients presented over a 4-year period with pain and dysfunction which had failed to respond to conservative management. Open surgery was carried out on all TMJs and operative findings compared with the results of imaging. The clinical diagnosis of internal derangement was confirmed in every case by imaging and at surgery. Arthrotomography over-diagnosed non-reducibility of an anteriorly displaced meniscus and perforation. MRI over-diagnosed non-reducibility to a lesser extent and under-diagnosed perforation. MRI demonstrated neither bony changes nor adhesions. Dynamic arthrotomography produced the best images of meniscal derangement in function and the pre-arthrogram tomograms were the best indicator of osseous abnormality. Arthrotomography was the preferred imaging technique.
对48例因临床诊断为颞下颌关节内紊乱而考虑手术的患者的50个颞下颌关节进行了关节造影和磁共振成像（MRI）检查。这些患者在4年期间出现疼痛和功能障碍，保守治疗无效。对所有颞下颌关节进行了开放手术，并将手术结果与影像学结果进行了比较。影像学和手术均证实了每例患者的颞下颌关节内紊乱临床诊断。关节造影过度诊断了前移位半月板的不可复性和穿孔。MRI在较小程度上过度诊断了不可复性，而对穿孔的诊断不足。MRI未显示骨质改变和粘连。动态关节造影产生了半月板功能紊乱的最佳图像，关节造影前的断层扫描是骨质异常的最佳指标。关节造影是首选的成像技术。
