健康成年人颞下颌关节上腔造影螺旋CT扫描图像分析

Analysis of spiral CT arthrography of superior joint space in healthy adult temporomandibular joint

目的探讨健康成年人开闭口位颞下颌关节(TMJ)上腔造影螺旋CT扫描图像的三维断面形态。方法选择5名健康成年男性志愿者,左侧TMJ上腔行76%泛影葡胺造影,在开闭口位行螺旋CT扫描,分别截取经关节窝顶点的矢状面和冠状面图像以及关节窝高度中点的横断面图像,并与3具TMJ局部解剖标本进行对照,分析关节上腔形态与下颌运动的关系。结果健康成年人闭口位关节上腔造影的矢状面、冠状面及横断面图像分别为"S形"、"半圆弧形"和"圆环形";开口位关节上腔造影的矢状面、冠状面及横断面图像分别为"月牙形"、中间部分扩张的"S形"和"半圆形";关节上腔形态能反映关节盘在开闭口运动中的位置变化和颞骨关节面的形态。结论健康TMJ上腔造影经螺旋CT扫描的图像能综合反映关节上腔及其毗邻组织在开闭口位的形态和结构,为颞下颌关节疾病的影像学检查提供正常对照资料,为TMJ的生理运动和临床诊断研究提供依据。

Objective To investigate the three-dimensional sections of spiral CT arthrography of superior joint space at opening and closing positions in healthy adult temporomandibular joint （TMJ）. Methods Five healthy adult male volunteers were enrolled and 76% diatrizoate contrast was injected to the left TMJ superior joint space. Spiral CT scanning was performed at opening and closing positions. Then the cross-sections in sagittal and coronal plane crossing the apex of glenoid fossa and transvers plane through the middle height of glenoid fossa were intercepted. The relationship between the shape of superior joint space and the mandibular movement was analyzed by comparing the images with those from three TMJ local anatomical specimens. Results In closing position,the shapes of arthrography of TMJ superior joint space on the sagittal,coronal and transverse plane were ＂S＂,＂semi-circular arc＂ and ＂annular＂; In opening position,the images of sagittal,coronal and transverse plane were ＂Crescent＂,＂＇ S-shaped＇ with the middle part expansion＂ and ＂semi-circular＂; The shape of superior joint space reflected the positional changes of articular disk during opening and closing movement,and also reflected the shape of articular surface of temporal bone. Conclusions Spiral CT arthrography of healthy TMJ superior joint space comprehensively revealed the conformation and structure of the superior joint space and its adjacent tissue at opening and closing positions; The research provided the normal control data for radiological examination of TMJ disease,and the basis for physical and clinical research.