颞下颌关节紊乱病磁共振诊断的研究

目的:研究MRI对颞下颌紊乱病诊断的准确性和可信性.方法:利用MRI对19例单侧关节疼痛颞下颌关节紊乱病(TMD)患者38侧关节完成开闭口斜矢状位T1和T2加权成像,观察盘突关系、盘形态改变及关节腔内积液情况.利用关节镜诊断为金标准判定MRI诊断的准确率.同期行灌洗术治疗,分析治疗前后不同时期患者的疼痛值(疼痛直观模拟标尺VAS)变化.结果:MRI检查结果显示在患侧89.47%(17/19)显示不可复性关节盘移位,10.53%(2/19)显示可复性关节盘移位,47.37%(9/19)关节上腔前隐窝出现积液.在健侧15.79%(3/19)显示可复性关节盘移位,无不可复性关节盘移位和腔内积液出现.通过关节镜手术对患侧进行检查,关节盘移位在MRI片上均得到证实,MRI检查的准确率为100%,灌洗术后疼痛100%有显著缓解(P<0.001).结论:颞下颌关节紊乱病与关节盘移位和腔内积液密切相关,通过MRI检查可以准确有效的对颞下颌紊乱病进行诊断,灌洗术对关节疼痛治疗效果显著.

MRI Diagnosis of Temporomandibular Disorders

Objective: To investigate whether temporomandibular disorders(TMDs) are related to magnetic resonance imaging(MRI) diagnoses.Methods: The study comprised 19 patients with a clinical unilateral TMDs.Bilateral MRI was used to find effusion,disc displacement,and disc form with clinical findings of pain and sounds in patients.TMJ arthroscopy was used to assess the reliability of MRI results,and lavage were used at the same time.Results: Disc displacement was confirmed by MRI in 22 joints from 19 patients(total 38 joints).In injured joints,89.47%(17/19)joints showed anterior disk without reduction(ADDWR),10.53%(2/19)joints showed anterior disk with reduction(ADDR),and 47.37%(9/19)joints showed effusion.In uninjured side 15.79%(3/19)joints showed anterior disk with reduction(ADDR),without effusion and ADDWR.TMJ arthroscopies of injured joints proved that MRI results were 100% correct.After the operation,jaw pain had also significantly improved(P<0.001).Conclusions: TMDs are closely related to disc position and effusion in the joint.MRI diagnoses are reliable to TMDs.Arthroscopy and lavage are effective in reducing pain in patients with TMDs.