CBCT and MRT imaging in patients clinically diagnosed with temporomandibular joint arthralgia.
CBCT and MRT imaging in patients clinically diagnosed with temporomandibular joint arthralgia.
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DOI：
10.1016/j.heliyon.2018.e00641
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发表时间：
2018-06
期刊：
影响因子：
4
通讯作者：
Grunert I
中科院分区：
文献类型：
--
作者：
Schnabl D;Rottler AK;Schupp W;Boisserée W;Grunert I
比较锥束计算机断层扫描（CBCT）和磁共振断层扫描（MRT）对颞下颌关节（TMJ）关节痛患者骨结构的评价，并将CBCT测量的关节间隙距离与MRT显示的椎间盘形态和位置相关联。对13例临床诊断为颞下颌关节痛的患者的26个颞下颌关节（TMJs）进行CBCT和MRT检查。使用表格对所有图像进行评估。比较了各种影像学方法对骨结构诊断的符合性。cbct图像中测量的前、上、后关节间隙距离与MRT中显示的椎间盘形态和位置有关。CBCT和MRT在评估骨性TMJ结构方面的符合性为69.3%至96.6%。CBCT检测到的骨改变，如糜烂、骨赘和囊肿，部分不能被MRT识别。关节间隙距离与椎间盘形态（双凹或非双凹）的相关性无统计学意义。关节间隙距离与椎间盘位置的相关性仅对上关节距离有统计学意义。在骨改变的可视化方面，CBCT优于MRT，这是区分单纯性关节痛和骨关节炎的关键。因此，在临床上诊断为TMJ关节痛的患者中，CBCT成像是合适的。矢状位CBCT显示上关节间隙距离不是最高关节间隙提示前盘移位。对于经常与骨变化相关的结构变化或椎间盘移位的可视化，MRT是最佳工具。因此，两种成像方法的结合可以对TMJ关节痛患者进行全面的诊断。
To compare cone beam computed tomography (CBCT) and magnetic resonance tomography (MRT) in patients with temporomandibular joint (TMJ) arthralgia in respect of the evaluation of bony structures, and to correlate joint space distances measured in CBCT with the morphology and the position of the disc visualized in MRT. 26 temporomandibular joints (TMJs) in 13 patients clinically diagnosed with TMJ arthralgia were examined by both CBCT and MRT. All images were evaluated by use of a form. The results were compared in regard of conformability of the diagnoses of osseous structures established by each imaging method. Anterior, superior and posterior joint space distances measured in CBCT-images were related to disc morphology and position visualized in MRT. Conformability of CBCT and MRT in the evaluation of bony TMJ structures ranged from 69.3 to 96.6 %. Osseous alterations such as erosions, osteophytes and cysts detected by CBCT could partly not be discerned by MRT. The correlation of joint space distances with disc morphology (biconcave or not biconcave) was not statistically significant. The correlation of joint space distances and disc position was statistically significant only for the superior joint distance. CBCT outclasses MRT in the visualization of osseous alterations, which are diacritic in the differentiation of simple arthralgia from osteoarthritis. Therefore, CBCT imaging is appropriate in patients clinically diagnosed with TMJ arthralgia. Superior joint space distance not being the highest joint space in sagittal CBCT indicates an anterior disc displacement. For the visualization of structural changes or displacement of the disc frequently associated with osseous changes, MRT is the optimal tool. Thus, the combination of the two imaging methods allows a comprehensive diagnosis in TMJ arthralgia patients.