髁突骨折急性期颞下颌关节MRI表现

MRI Manifestation of Temporomandibular Joint in Acute Stage of Condylar Fracture

目的探讨MRI在髁突骨折后颞下颌关节软组织损伤中的诊断价值。方法选取我院急性单侧或双侧髁突骨折17例行MRI检查,根据受伤的严重程度及损伤的类型进行分类、分级,分析髁突损伤程度与颞下颌关节软组织损伤的相关性。结果 17例共23个髁突骨折,其中14个为髁突Ⅱ级损伤,9个为Ⅲ级损伤。Ⅱ级、Ⅲ级损伤中出现关节盘移位分别为8个(57.1%)、9个(100.0%),关节内出血为5个(35.7%)、9个(100.0%),组间比较差异有统计学意义(P<0.05);关节囊撕裂分别为1个(7.1%)、2个(22.2%),组间比较差异无统计学意义(P>0.05)。髁突骨折损伤程度与关节盘移位、关节内出血呈明显正相关性(r=0.691、0.643),与关节囊撕裂无明显相关性(r=0.219)。结论 MRI可明确诊断髁突骨折患者颞下颌关节软组织损伤,且髁突损伤程度越重,关节盘移位、关节内出血概率越高。

Objective To investigate the value of magnetic resonance imaging （MRI） in diagnosis of the temporomandibular joint （TMJ） and soft tissue injuries after condylar fractures.Methods Seventeen patients with acute unilateral or bilateral condylar fractures were examined with MRI,and were further classified and graded according to the severity and types of injuries.The correlation between injury degrees of condylar process and soft tissue injury of TMJ was analyzed.Results For the 17 patients,23 joints had condylar fractures,including 14 joints with grade Ⅱ injury and 9 joints with grade Ⅲ.8 joints （57.1％） and 9 joints （100.0％） had articular disc displacement,while 5 joints （35.7％） and 9 joints （100.0％） had hemarthrosis in grade Ⅱ and grade Ⅲ injuries respectively,and the differences were statistically significant in group comparison （P ＜ 0.05） ; 1 joint （7.1％） and 2 joints （22.2％） had capsular tearing in grade Ⅱ and grade Ⅲ injuries respectively,but the differences showed no statistical significance in group comparison （P ＞0.05）.There was a positive correlation between the degree of condylar injury with articular disc displacement and hemarthrosis （r =0.691,0.643）,but the capsular tearing was not significantly associated with the degree of condylar injury （r =0.219）.Conclusion MRI is effective in diagnosis of the TMJ and soft tissue injuries after condylar fractures.The worse the condylar is injured,the higher incidence rates of articular disc displacement and hemarthrosis have.