磁共振成像与数字减影关节造影诊断颞下颌关节紊乱综合征的比较研究

Temporomandibular joint disorders syndrome:comparison between MR imaging and digital subtraction arthrography

34例（41侧对）临床诊断为颞下颌关节紊乱综合征的患者，接受了磁共振成像和数字减影造影检查。磁共振成像检查对人体无侵害性损伤，无放射性损害，能根据需要行各个位置如冠状、矢状、轴位的任意方向的扫描，显示和区别骨组织、肌肉、关节盘及关节韧带等结构极为理想，但对关节盘穿孔不易诊断且费用较高。数字减影可消除周围组织的干扰，显示关节盘的形态，特别是对关节盘穿孔者诊断尤为理想，但需要注射造影剂，对盘突关系观察不理想。两种方法有互补性，可提高对颞下颌关中紊乱综合征的诊断水平，便于制定治疗方案，有临床实用价值。

34 patients (41 joints) diagnosed clinically as having internal derangement oftemporomandibular joint (TMJ) were examined by magnetic resonance imaging (MRI) and digital subtractionarthrography(DSA). MRI can be obtained in any cross-sectional plane, and the images consist ofpicture elements (pixels) generated by computer technology. Due to the good demonstration of osseous,muscular and disco-ligament structures is the method of choice for TMJ evaluation. However, MRimaging is limited in that it cannot show diagnose a meniscal perforation. DSA found to be the bestimaging modality for a meniscal perforation.,DSA was used only during contrast injection. Both MRIand DSA help each other for diagnosis internal derangements of TMJ. This study suggests that MRIand DSA could be clinical valuable tool for internal derangement of TAJ.