MRI动态扫描诊断颞下颌关节紊乱的价值

The Value of Dynamic MRI Scanning in Diagnosing Temporomandibular Joint Disorder

目的:探讨MRI动态扫描诊断颞下颌关节紊乱(TMD)的价值。方法:选取2022年8月至2023年12月本院收治的34例疑似TMD患者为对象,均接受MRI平扫及动态扫描检查。以随访及手术结果为参照,分析MRI平扫及动态扫描诊断TMD的价值。结果:MRI动态扫描诊断TMD的灵敏度为95.00%、特异度为100.00%、准确度为97.06%、Kappa值为0.94。MRI常规扫描诊断TMD的灵敏度为90.00%、特异度为92.86%、准确度为91.18%、Kappa值为0.82。MRI常规扫描诊断TMD的准确度、灵敏度、特异度与MRI动态扫描比较,差异无显著性(P>0.05)。34例患者经MRI动态扫描显示,12例(35.29%)患者关节盘的位置正常,11例(32.35%)患者可见可复性的关节盘位置前移,7例(20.59%)患者可见不可复性关节盘前移,2例(5.88%)患者可见关节盘内移位,2例(5.88%)患者可观测到关节盘外移位。结论:MRI动态扫描用于TMD患者,可清晰的显示关节的结构,了解其动态运动情况,更好的诊断TMD。

Objective:to evaluate the value of MRI dynamic scanning in the diagnosis of temporomandibular joint disorders.Methods:34 patients with suspected TMD treated in our hospital from August 2022 to December 2023 were examined by MRI plain scan and dynamic scan.The value of plain scan and dynamic scan of MRI in the diagnosis of TMD was analyzed with reference to the results of follow-up and operation.Results:the sensitivity,specificity,accuracy and Kappa value of MRI dynamic scan in the diagnosis of TMD were 95.00%,100.00%,97.06%and 0.94 respectively.The sensitivity,specificity,accuracy and Kappa value of MRI conventional scan in the diagnosis of TMD were 90.006%,92.86%,91.18%and 0.82 respectively.There was no significant difference in the accuracy,sensitivity and specificity between MRI routine scan and MRI dynamic scan in the diagnosis of TMD.Dynamic MRI scan showed that the position of articular disc was normal in 12 cases(35.29%),reversible anterior displacement of articular disc was seen in 11 cases(32.35%),irreducible anterior displacement of articular disc could be seen in 7 cases(20.59%),intra-articular disc displacement could be seen in 2 cases(5.88%),and external displacement of articular disc could be observed in 2 cases(5.88%).Conclusion:MRI dynamic scanning in patients with TMD can clearly show the structure of the joint,understand its dynamic movement,and better diagnose TMD.