摘要
目的探讨颞下颌关节疼痛与颞下颌关节内紊乱(TMJID)、关节盘形变、渗出液及颞下颌关节骨关节炎(TMJOA)的关系。方法利用MRI金标准,对44例单侧关节疼痛TMD患者88侧关节,完成开闭口矢状位T1W和闭口斜矢状位T2W扫描,双侧关节MRI自身对比研究,在单盲下经两名放射科大夫观察影像学特征,判断颞下颌关节盘移位类型、关节盘形态、关节渗出液及髁突骨形态,探讨颞下颌关节疼痛与TMJID、关节盘形变、关节渗出液及TMJOA的关系。结果 44个疼痛关节中,30个关节(68.2%)表现为TMJID,其中11个关节(25%)为可复性关节盘移位(ADDR),19个关节(43.2%)为不可复性关节盘移位(ADDWR);而44侧非疼痛颞下颌关节中ADDR为6个关节(13.6%),其余正常。TMJID及TMJID的类型与颞下颌关节疼痛均有统计学意义(P<0.05)。44个疼痛关节中关节盘变形为35个关节(88.6%);而44侧非疼痛颞下颌关节中仅4个关节盘变形(9%)。颞下颌关节盘变形与疼痛有统计学意义(P<0.05)。少量渗出液关节除外后,44侧疼痛颞下颌关节中,渗出液为13个关节(29.5%),其中9个关节(20.5%)为中等渗出液,4个关节(9%)大量渗出液;而44侧非疼痛颞下颌关节中,渗出液仅1个关节(2.3%)。颞下颌关节渗出液与疼痛有统计学意义(P<0.05)。在44侧疼痛颞下颌关节中,11个关节(25%)有骨改变,髁突变平2侧,髁突破坏、骨赘、髁突短小各3侧;而44侧非疼痛颞下颌关节中,仅1侧髁突后斜面为凹陷型骨缺损(2.3%)。颞下颌关节TMJOA与疼痛有统计学意义(P<0.05)。结论颞下颌关节疼痛与TMJID、关节盘形变、关节渗出液及TMJOA密切相关。
Objective To investigate the correlation between temporomandibular joint pain and temporomandibular joint internal derangement（ TMJID）, articular disc deformity, joint effusion, temporomandibular joint osteoarthritis（ TMJOA）. Methods Forty-four patients with temporo-mandibular disorders（ TMD） were enrolled in the study,and a total of88 joints were examined by oblique sagittal T1 and sagittal T2 weighted MR scanning to observe the types of discus articularis articulationis mandibularis,articular disc shape,joint effusion and condylar process bone shape,moreover,the correlation between temporomandibular joint pain and TMJID,articular disc deformity,joint effusion,TMJOA was analyzed. Results Among 44 pain joints,30 joints（ 68. 2） showed TMJID,in which,11 joints（ 25%） were ADDR,and 19 joints 43. 2% were ADDWR,however,among 44 temporomandibular joints without pain,6 joints（ 13. 6%） had ADDR,the other joints were normal. There was a significant difference between temporomandibular joint pain and TMJID as well as TMJID type（ P〈0. 05）. Among 44 pain jionts,35 joints（ 88. 6%） had articular disc deformation,however,in 44 temporomandibular joints without pain,only 4 joints（ 9%） had articular disc deformation,and there was a significant difference between temporomandibular joint disc deformation and pain（ P〈0. 05）. Moreoover among 44 temporomandibular joints with pain,13 joints（ 29. 5%） had joint effusion,in which,9 joints（ 20. 5%） had moderate volume joint effusion,and 4 joints（ 9%） had a great amount joint effusion,however,within 44 temporomandibular joints without pain,only 1 joint（ 2. 3%） had joint effusion,and there was a significant difference between temporomandibular joint effusion and pain（ P〈0. 05）. among 44 temporomandibular joints with pain,11 joints（ 25%） had bone change,with 2 cases of flattened condyle process and condyle process destruction,bony outgrowth, short and small condyle process, respectively in 3 cases,however, among 44 temporoman
出处
《河北医药》
CAS
2018年第2期239-242,共4页
Hebei Medical Journal
关键词
颞下颌关节
疼痛
TMJID
关节盘形变
渗出液
TMJOA
核磁共振
temporomandibular joint
pain
temporomandibular joint internal derangement
articular disc deformity
transudate
temporomandibular joint osteoarthritis
magnetic resonance imaging
