颞下颌关节滑膜软骨瘤病的临床及影像学特征分析

Analysis of clinical and imaging characteristics of synovial chondromatosis of temporomandibular joint

目的研究人颞下颌关节滑膜软骨瘤病的临床及影像特征,为通过锥形束CT(CBCT)造影检查提供诊断依据。方法采用回顾性研究1998年6月至2015年7月在中山大学附属口腔医院收治的21例组织病理学上诊断为滑膜软骨瘤病的患者,对其临床表现、影像检查、手术治疗、组织病理学特征等进行研究,对其CBCT造影检查的特征进行概括总结。结果颞下颌关节滑膜软骨瘤病多发生在女性,主要症状包括关节区肿胀、关节杂音、关节周围疼痛、张口受限等。CBCT造影检查可检测出关节腔内的软骨小体。滑膜软骨瘤病主要发生于关节上腔,同时也可发生于关节下腔,而CBCT造影检查可轻易检测出病变有无合并关节盘的穿孔。结论CBCT造影检查在滑膜软骨瘤病关节腔中可见特征性的类圆形缺损,其对关节滑膜软骨瘤病的诊断有重要帮助。

Objective To study the clinical and radiologic findings of synovial chondromatosis(SC) and provide a reference for its radiologic diagnosis by using cone-beam computed tomography(CBCT) arthrography. Methods Twenty-one patients presenting to our clinic with SC diagnosed histopathologically were included in the study. The clinical manifestations,radiographic findings,surgical treatment,and histopathologic features of the disease were investigated. The features of SC of the temporomandibular joint (TMJ)on CBCT arthrography were summarized. Results SC of the TMJ occurred more often in women. Its main symptoms included swelling,crepitations,preauricular pain,and limitation of mandibular movement. The detection rate of calcified loose bodies was 100% on CBCT arthrography. SC mainly affected the superior joint space and could involve the inferior space through a perforated disc and could be easily detected with CBCT arthrography. Conclusions The characteristic round-like filling defect of SC of the TMJ could be easily detected on CBCT arthrography images. Therefore,CBCT arthrography with contrast medium injection plays an important role in the diagnosis of SC.