共查询到20条相似文献,搜索用时 15 毫秒
1.
Farina D Bodin C Gandolfi S De Gasperi W Borghesi A Maroldi R 《European journal of radiology》2009,70(1):25-30
Though magnetic resonance (MRI) is a widely accepted standard for the assessment of patients with temporomandibular joint (TMJ) disorders, efforts to correlate symptoms to MRI findings have often given controversial results. Aim of this study was to investigate the correlation between TMJ pain and findings of contrast-enhanced MRI. Thirty-eight consecutive patients with TMJ dysfunction syndrome (study group) were examined with MRI. Protocol included T2 turbo spin-echo sequence, T1 spin-echo sequence, and T2 gradient-echo (acquired with closed jaw, at intermediate and maximal opening). Post-contrast phase was obtained through a fat sat 3D T1 gradient-echo sequence (VIBE). Post-contrast findings in the study group were matched with those obtained in a control group of 33 patients submitted to MRI of the paranasal sinuses. Statistically significant difference was found between condylar medullary bone enhancement in painful TMJ, in painless TMJ and control group. In addition the average thickness of joint soft tissue enhancement in painful TMJ was superior to painless TMJ (p<0.0001) and to control group. On multivariate logistic regression analysis, the odds ratio that a painful TMJ showed disk displacement, osteoarthrosis, effusion and JST enhancement were 3.05, 3.18, 1.2 and 11.36, respectively. Though not histologically proven, TMJ enhancement could reflect the presence of inflammation in painful joints. Furthermore, the administration of contrast could be of help for the assessment of patients with orofacial pain, particularly when clinical exploration is insufficient to ascribe the pain to TMJ. 相似文献
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目的 在3.0 T场强中,比较常规髋关节MRI及MR髋关节造影对髋臼唇撕裂的诊断价值.方法 回顾分析44例髋关节病变患者的患侧髋关节常规MRI及MR髋关节造影资料,将每例患者的臼唇划分为前、上、后3处区域(共计132处),确定有无撕裂,并进行分型.其中5例患者经髋关节镜检查.对于常规MRI及MR髋关节造影获得的臼唇撕裂及分型数据差异比较采用Wilcoxon秩和检验,一致性比较采用Kappa检验.结果 常规MRI与MR髋关节造影诊断完全相同者计116处臼唇,只有16处存在诊断差异.其中,前者诊断无撕裂而后者诊断撕裂者9处,前者诊断撕裂但后者诊断无撕裂者6处,其余1处两者均诊断为撕裂但分型不同.常规MRI与MR髋关节造影的评价差异没有统计学意义(Z=0.347,P>0.05),且具有极好的一致性(K=0.781,P<0.01).在接受关节镜的5例患者中,常规MRI、MR髋关节造影及关节镜结果均完全吻合.结论 对髋臼唇撕裂,3.0 T常规髋关节MRI可获得与MR髋关节造影基本相同的诊断效果. 相似文献
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Nahla Mohamed Ali Hasan Tarek Elsayed Ftohy Abdelrahman 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Objective
To evaluate the relationship between anterior disc displacement (ADD) degree and other temporomandibular joint (TMJ) soft tissues and osseous abnormalities in symptomatic TMJ dysfunction based on magnetic resonance imaging findings.Patients and methods
MR images of 106 TMJs in 53 patients, presented with symptomatic TMJ dysfunction were included. Degree of ADD was detected and its relationship to joint effusion, retrodiscal layer integrity, thickness of lateral pterygoid muscle (LPM) attachments, degenerative changes and condylar position and translation as well as clinical manifestations was studied.Results
Compared with normal disc position, risk of joint effusion and degenerative changes were significantly increased with increased degree of ADD (p < 0.05). LPM attachment thickening and retrodiscal layer abnormalities are significantly associated with an advanced degree of ADD (p < 0.05). Risk of ADD is significantly increased with posterior position of the condyle within the fossa.Conclusion
There is a direct relationship between the ADD degree and other TMJ soft tissues and bone abnormalities as well as the severity of clinical manifestations, so early MRI detection and reporting of ADD degree and other MRI findings might help clinicians in full assessment and determining strategy of management of TMJ dysfunction. 相似文献5.
A J Hopfgartner O Tymofiyeva P Ehses K Rottner J Boldt E-J Richter P M Jakob 《Dento maxillo facial radiology》2013,42(9)
Objectives:
The objective of this study was to examine the kinematics of structures of the temporomandibular joint (TMJ) under physiological load while masticating.Methods:
Radial MRI was chosen as a fast imaging method to dynamically capture the motions of the joint’s anatomy. The technique included a golden ratio-based increment angle and a sliding window reconstruction. The measurements were performed on 22 subjects with and without deformation/displacement of the intra-articular disc while they were biting on a cooled caramel toffee.Results:
The reconstructed dynamic images provided sufficient information about the size and localization of the disc as well as the change of the intra-articular distance with and without loading.Conclusions:
The feasibility of the golden ratio-based radial MRI technique to dynamically capture the anatomy of the TMJ under physical load was demonstrated in this initial study. 相似文献6.
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D Resnick R Kerr M Andrè J Guerra R O Cone D Atkinson C Pineda 《Investigative radiology》1984,19(5):432-437
Digital arthrography was accomplished in 16 patients who had painful prostheses. In each instance, resulting arthrographic abnormalities were compared with those apparent on subsequent overhead radiographs. Results indicate the potential value of the digital technique in this clinical setting. The examination is easy to perform and rapid, and allows the examiner to view the changing images in the subtraction mode. Image manipulation and enhancement are also possible. 相似文献
8.
MR arthrography for evaluation of the acetabular labrum 总被引:1,自引:0,他引:1
Petersilge CA 《Skeletal radiology》2001,30(8):423-430
MR arthrography of the hip has provided new insights into the lesions underlying mechanical hip pain. Until now evaluation
of these structures, especially the acetabular labrum, has been limited. With the joint distention provided by MR arthrography,
labral detachments and intrasubstance tears can be identified and differentiated from the many varied appearances of the asymptomatic
labrum. This article reviews the normal anatomy of the hip, the clinical presentation of internal derangement and the technique
for performing MR arthrography. The variations in morphology and signal of the asymptomatic labrum are reviewed as well as
the appearance of the abnormal labrum.
Received: 16 January 2001 Revision requested: 21 January 2001 Revision received: 19 April 2001 Accepted: 19 April 2001 相似文献
9.
Objectives:
To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers.Methods:
The oblique coronal closed- and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test.Results:
The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (−16.6%). In the open-jaw position, both the medial and the lateral edges shifted medially (to 17.6% vs −23.6%, Wilcoxon matched-pair test, p < 0.001). OA had no significant influence (generalized estimation equation model, p = 0.952). The disc position differed significantly from asymptomatic individuals (t-test, p < 0.001) who showed a medial disc position and full coverage of the condyle.Conclusions:
In patients with TMJ pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar. 相似文献10.
Purpose. In a patient with internal derangement of the shoulder, the diagnostic method of choice is controversial. Conventional arthrography
can diagnose most rotator cuff tears accurately; however, in many institutions MR arthrography is usually necessary to diagnose
labral tears. We utilized decision tree methodology to compare the cost- effectiveness of conventional arthrography and conventional
MRI with a hypothetical algorithm in which a patient underwent arthrography, performed with admixed gadolinium, which if negative,
was followed by MRI.
Design. The use of double-contrast arthrography alone, conventional MRI alone, and gadolinium-enhanced MRI used as an adjunct to
conventional arthrography were modeled for the diagnosis of full-thickness rotator cuff tears (RCT), partial RCTs, labral
tears, and the absence of cuff/labral tears using decision analysis methodology. English language medical publications were
searched to determine the base probabilities for the accuracy of the diagnostic tests. The outcome utilities ranged from –1
to +1 to reflect the value of correct diagnostic evaluation. Charges for diagnostic tests and appropriate surgical treatments
were based on 1997 Medicare reimbursement rates for professional fees and hospital charges in an outpatient setting. Sensitivity
analyses were performed to evaluate the effects of uncertainty regarding the prevalence of each disease state and the accuracy
of several diagnostic tests.
Results. In the base-case analysis, the average effectiveness of double-contrast arthrography alone, MRI alone and arthrography selectively
followed by MRI were 0.6610, 0.6715, and 0.7204, respectively. The average costs for each of these strategies were $1090,
$2033, and $2339, respectively.
Conclusion. Arthrography performed with admixed diluted gadolinium, which if negative is immediately followed by MRI, was somewhat more
expensive than conventional MRI. However, because of much greater effectiveness, cost-effectiveness was significantly higher
for our proposed algorithm. Conventional arthrography without gadolinium, although less expensive, had severely limited effectiveness.
Received: 4 June 1999 Revision requested: 6 August 1999 Revision received: 30 August 1999 Accepted: 1 September 1999 相似文献
11.
PET, CT, and MRI in the evaluation of neuropsychiatric disorders: current applications 总被引:3,自引:0,他引:3
Positron emission tomography (PET) is emerging as a very useful clinical tool and is adding a great deal to our understanding of the pathophysiology of central nervous system (CNS) disorders. Although computed tomography (CT) and magnetic resonance imaging (MRI) have had a dramatic impact on patient management, there is often an important associated function abnormality which is best assessed by PET. In normal aging and in dementia, the CT and MRI brain changes of atrophy and white matter abnormalities are frequently nonspecific. PET has been more diagnostic, showing characteristic regional metabolic abnormalities. Evaluation of brain tumors such as astrocytomas with PET has demonstrated better correlation with histologic grade compared to CT. Unlike CT or MRI, PET can help to distinguish radiation necrosis from recurrent tumor, and can differentiate the extent of metabolically active tumor from surrounding edema. PET is useful in evaluating stroke patients, providing better prognostic information and demonstrating abnormalities sooner than CT. In epilepsy, PET appears to be superior to MRI in localizing seizure foci in patients with partial seizures. In head trauma patients, metabolic patterns are being described which will likely have an effect on patient management. The use of PET in schizophrenia has yielded very interesting results, with common patterns of metabolic abnormalities being demonstrated. CT and MRI in these patients have not been very useful. PET has also shown promise in movement disorders such as Huntington's disease. It is now clear that PET is already clinically useful and can provide valuable information unobtainable by CT and MRI. As new radioligands are developed, PET is certain to assume an even more important role in the future. 相似文献
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This pictorial review illustrates the anatomical features of normal intra-articular components of the hip and their common
disorders on MR arthrography. On T1-weighted MR arthrograms, the normal contrast-filled joint cavity shows a homogeneous high
signal intensity. Normal acetabular labrum appears as a well-delineated triangle showing a low signal intensity, surrounded
by contrast material in the perilabral recess. Intra-articular paramagnetic contrast outlines labral tears, loose bodies,
communicating labral cysts and cartilage lesions (traumatic tears, focal defects, degenerative fissures and thinning), and
improves their detection. Overall, MR arthrography enables accurate detection and staging of hip intra-articular structure
abnormalities.
Received: 6 June 1998; Revision received: 2 January 1999; Accepted: 2 April 1999 相似文献
14.
Kurita H Kojima Y Nakatsuka A Koike T Kobayashi H Kurashina K 《Dento maxillo facial radiology》2004,33(5):329-333
OBJECTIVES: The purpose of this study was to analyse the relationship between temporomandibular joint (TMJ)-related pain and morphological change of the TMJ condyle in patients with temporomandibular disorders. METHODS: Data were obtained from 178 joints in 89 patients. The joints were clinically assessed for pain on mandibular function and on lateral palpation of the TMJ. They were also assessed for radiographic evidence of bone change at the articular surface (OAAS) and resorption of the lateral part of the condyle (RLC). RESULTS: A higher prevalence of joint pain on function was observed in joints with OAAS than in those without OAAS (Chi-square test of independence, P < 0.05). Significant relationships were found between palpation pain and OAAS and between palpation pain and RLC (Chi-square test of independence, P < 0.05). In addition, patients with RLC showed a significantly lower pain threshold for external mechanical stimuli than those without RLC (Welch's t-test, P < 0.05). CONCLUSIONS: These results suggest a possible relationship between pain on function and OAAS as well as a relationship between palpation pain and RLC. Pain on lateral palpation may be related to the pathological conditions that induce RLC. 相似文献
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Toomayan GA Holman WR Major NM Kozlowicz SM Vail TP 《AJR. American journal of roentgenology》2006,186(2):449-453
OBJECTIVE: MRI has historically provided suboptimal visualization of tears of the acetabular labrum. Degenerative fraying and underlying cartilage abnormalities can often mimic tears of the labrum on conventional MRI. Administration of intraarticular gadolinium enhances the MRI appearance of the labrum to improve detection of labral abnormalities. This study examined the improved diagnostic sensitivity of MR arthrography compared with conventional MRI and the importance of confining the study to a small field of view. MATERIALS AND METHODS: Fifty-one hips were imaged in 48 patients. Fourteen hips underwent conventional MRI with a large field of view (30-38 cm). Seven hips underwent conventional MRI with a small field of view (14-20 cm). Thirty hips underwent MR arthrography with a small field of view (14-20 cm). Labral tears were diagnosed when contrast material was identified within the labrum or between the labrum and the acetabulum, when a displaced fragment was noted, or when a paralabral cyst was identified. All study results were compared with findings at the time of hip arthroscopy. RESULTS: Conventional MRI with a large field of view was 8% sensitive in detecting labral tears compared with findings at the time of arthroscopy. Diagnostic sensitivity was improved to 25% with a small field of view. MR arthrography with a small field of view was 92% sensitive in detecting labral tears. CONCLUSION: A combination of MR arthrography and a small field of view is more sensitive in detecting labral abnormalities than is conventional MRI with either a large or a small field of view. 相似文献
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T. K. Blanchard P. W. Bearcroft C. R. Constant D. R. Griffin A. K. Dixon 《European radiology》1999,9(4):638-642
Investigation of shoulder pain is important before surgical treatment. The presence or absence of a full-thickness rotator
cuff tear (FTRCT) may determine the type of surgical treatment. Both MRI and conventional arthrography can be used, but little
is known about their relative diagnostic and therapeutic impact. We performed a prospective trial assessing: (a) the influence
of MRI and arthrography results on the clinician's diagnostic thinking (diagnostic impact); (b) the influence of the results
on the clinician's therapeutic thinking (therapeutic impact); and (c) the diagnostic performance of the two techniques in
patients with surgical confirmation. A total of 104 consecutive patients with shoulder problems referred to a specialist orthopaedic
shoulder clinic underwent pre-operative investigation with MRI and arthrography. The surgeon's diagnosis, diagnostic confidence
and planned treatment were measured before the investigation, and then again after the results of each investigation. Before
the presentation of the investigation results, the patients were randomised into two groups. In one group MRI was presented
first; in the other group, arthrography. The MRI results led to fewer changes in diagnostic category (14 of 46, 30 %) than
arthrography (20 of 54, 37 %), but the difference was not significant (P > 0.5). Magnetic resonance imaging led to slightly more changes in planned management (17 of 47, 36 %) than arthrography
(14 of 55, 25 %), but again the difference was not statistically significant (P > 0.3). The results of the second investigation always had less diagnostic and therapeutic impact than the first. The accuracy
of MRI for FTRCT in 38 patients with surgical confirmation was 79 %, sensitivity 81 % and specificity 78 %; the accuracy of
arthrography was 82 %, sensitivity 50 % and specificity 96 %. The clinical diagnosis and management plan can be adequately
defined by a single radiological investigation. Magnetic resonance imaging and arthrography had fairly similar diagnostic
and therapeutic impact and comparable accuracy, although MRI was more sensitive and less specific. Magnetic resonance imaging
may be the preferred investigation because of its better demonstration of soft tissue anatomy.
Received: 27 January 1998; Revision received: 27 May 1998; Accepted: 22 June 1998 相似文献
20.
Sherif A. Khedr Hassan Mahmoud Kassem Mostafa A. Azab 《The Egyptian Journal of Radiology and Nuclear Medicine》2013