SPECT-CT对成人下颌偏斜患者双侧颞下颌关节代谢及形态对称性研究

目的:利用SPECT-CT骨显像对成人下颌偏斜患者双侧颞下颌关节代谢及形态对称性研究。方法:对36例成人下颌偏斜患者行SPECT骨显像,对髁突、下颌升支、下颌角图像进行冠状面、矢状面、横断面采集进行三维重建,计算出放射性计数比值,并通过CT扫描三维重建后同机融合,根据双侧颞下颌关节解剖关系测量偏斜侧及对侧髁突的高度、内外径、后斜面倾斜角及后斜面长度的差异,进行对比观察。结果:颞下颌关节各区域(髁突、下颌升支、下颌角)放射性计数比值均有所不同,偏斜侧的放射性计数比值均低于对侧,且两侧放射性计数比值有显著差异(P＜0.05);偏斜侧髁突高度及内外径均较之对侧减小(P＜0.01);偏斜侧髁突后斜面长度、后斜面倾斜角较之对侧增大(P＜0.01)。结论:SPECT-CT骨显像对成人下颌偏斜疾病的诊断评估起到了至关重要的作用。

Study on Metabolism and Morphological Symmetry of Bilateral TMJ of Adult Patients with Mandibular Deviation using SPECT-CT.

Objective: To study metabolism and morphological symmetry of bilateral TMJ of adult patients with mandibular deviation by utilizing SPECT-CT. Methods: Thirty-six adult patients with mandibular deviation were conducted SPECT. The images of condyle process, mandibular ramus and angle of mandible were gathered and rebuilt from coronal, sagittal and cross section planes. Then, the radioactive count ratios were calculated and acquired fusion images after CT scanning and three-dimensional reconstruction. The condyle process height, internal and external diameters, back bevel slant angle and back bevel length were measured and compared according to bilateral TMJ's anatomic relation. Results: The radioactive counting ratios in different areas (condyle process, mandibular ramus, angle of mandible) were different, the radioactive counting ratios in the lateral side were lower than those of the opposite side, and the radioactive counting ratios of both sides showed statistical difference (P＜0.05). The condyle process height, internal and external diameters in the lateral side were smaller than those in the lateral side (P<0.01); Back bevel slant angle and length in the lateral side were larger than those in the opposite side (P<0.01). Conclusion: SPECT-CT bone imaging plays a crucial role in diagnosing and assessing mandibular deviation of adult patients.