1.5T MRI对单侧颞下颌关节紊乱综合征关节盘厚度与关节间隙的测量价值及相关性

The application value of 1.5T MRI in quantitative measure of the joint disc thickness and joint space in patients with unilateral temporomandibular joint disorder syndrome

目的研究1.5T MRI对单侧颞下颌关节紊乱综合征患者关节盘前移位治疗前关节盘厚度及关节间隙的测量价值及二者相关性。方法收集107例单侧发病颞下颌关节盘移位治疗前患者MRI图像,分为可复组(n=61)和不可复组(n=46),同期自身107例无病变侧颞颌关节为对照组。采用后处理软件在斜矢状位T2WI及PDWI上分别对双侧关节盘前、后带厚度及前、上、后关节间隙分别进行测量,并进行统计学分析。结果可复组患侧关节前间隙较健侧增宽,关节上间隙较健侧变窄,不可复组患侧仅关节前间隙较健侧增宽(P<0.05);患侧可复组关节盘前后带及不可复组后带较健侧均有增厚(P<0.05);健侧(可复与不可复组)关节盘后带厚度与关节前间隙呈正相关(r值分别为0.588和0.711,P<0.05),可复组患侧关节盘后带厚度与关节前间隙呈正相关性(r=0.413,P=0.001),但不可复组关节盘后带厚度与关节前间隙无相关性(r=0.249,P=0.096)。结论MRI对颞下颌关节紊乱可复性与不可复性关节盘前移客观诊断及预后评估具有一定临床价值。

Objective To investigate the application value of 1.5T MRI in quantitative measure of the joint disc thickness and joint space in patients with unilateral temporomandibular joint(TMJ)disorder syndrome.Methods The MRI images of 107 patients with unilateral TMJ before disc displacement treatment were collected,who were divided into the reversible group(n=61)and inreversible group(n=46),at the same time,the other 107 cases of TMJ without TMJ lesions were enrolled as control group.The postprocessing software was used to measure the anterior and posterior thickness of the bilateral joint disc and the anterior,upper and posterior joint spaces on oblique sagittal T2WI and PDWI,and results were statistically analyzed.Results The anterior joint space of the affected side in reversible group was wider than that on the healthy side,and the supracarticular space was narrower than that on the healthy side.The anterior joint space of the affected side in inreversible group was significantly wider than that on the healthy side(P<0.05).The anterior and posterior bands of the affected side in reversible group and inreversible group were significantly thicker than those on healthy side(P<0.05).There was a close correlation between the thickness of posterior disc and the anterior joint space on the healthy side both in reversible group and non-reversible group(P<0.01).There was a close correlation between the thickness of the posterior band of the affected side in reversible group and the anterior joint space(P<0.01),however,there was no correlation between the thickness of the posterior band of the affected side in inreversible group and the anterior joint space(P>0.05).Conclusion 1.5T MRI has a certain clinical value in diagnosis and prognosis evaluation of reversible and inreversible the antedisplacement of joint disc in patients with temporomandibular joint disorder.