颞下颌关节间接性损伤后MRI表现及其意义

MRI Manifestation of Temporomandibular Joints after Indirect Trauma

目的 :研究羊颞下颌关节 (TMJ)间接性损伤后关节结构的变化。方法 :用自制撞击装置造成山羊双侧颞颌关节间接性损伤 ,分别于伤后 2h、7d、1月、3月行MRI观察后处死取材 ,并进行组织学观察 ,正常关节作为对照。结果 :TMJ损伤后MRI观察发现 :TMJ间接性损伤后可导致关节软、硬组织结构的变化 ,在损伤早期 1月内表现为髁突表面软骨的碎裂 ,关节盘挫裂和移位 ,关节间隙的减小和关节腔内出现血性渗液 ;在损伤后期 1～ 3月表现为髁突表面软骨的破坏和吸收 ,关节盘畸形 ,关节间隙减小。结论 :MRI不但能够清楚、全面地反映关节损伤后软、硬组织结构和形态的变化 ,还是一种可用于研究TMJ损伤后转归和后遗症发生机理的较好的、精确的观察手段。

Objective: The objective of this study is to investigate the structure changes in temporomandibular joints (TMJs) of goats after indirect trauma. Methods: The trauma of TMJs of goats achieved under an impact to the right and left mandibular angles with a self_made device. These goats were killed after 2 hours, 7 days, 1 month and 3 months. The TMJs of goats were examined using MRI before killed and checked by histological method, the normal temporomandibular joints were treated as the control. Results: The results of MRI: in the early post_trauma stage, the condylar articular surface was partially lost, and the discs were displaced and ruptured. Further, the hemathrosis of the TMJ and the decreased joint spaces were also observed in the eroded, eburnous surface of the condyle and the deformed disc. In the later stage, the surfaces of condyles were eroded and eburnated, and the discs were deformed. Conclusion: The indirect trauma on the TMJs of goats can cause TMJ internal derangement and TMJ osteroarthrosis. MRI cab be used to investigate both hard and soft tissue injuries of the temporomandibular joint, and is appreciated in understanding the pathogenesis of indirect trauma on the TMJ.