背景:作者回顾性研究了磁共振成像(MRI)中关节盘的形态和位置与锥形束计算机断层扫描(CBCT)中髁的形态和位置之间的关系,旨在为颞下颌关节紊乱病的临床诊治提供参考。
方法:对同时具有CBCT和MRI影像学资料的患者进行回顾性研究,不包括TMJ肿瘤,骨折,严重髁突形态异常,非截口位置,图像质量差。共包括372名患者的744个颞下颌关节(TMJ),平均年龄为25.94±11.04Y(男性75岁,女性297岁)。MRI成像的T2加权图像(T2WI)用于评估椎间盘形态和椎间盘位移,同时获得CBCT以评估髁突骨骼和矢状髁位置。数据采用Pearson卡方检验和Spearman相关系数分析。
结果:744TMJS的后分布如下:1)椎间盘形态::挛缩(37.1%)>双凹(32.9%)>不规则(18.5%)>延长(11.4%);2)椎间盘位置:ADDWWoR(48.3%)>36.7%(21.6%)DWoar>PDR>(21.6%)不同性别间椎间盘形态和椎间盘位置的分布差异有统计学意义(P<0.05)。各年龄组间椎间盘位置和髁突形态分布差异有统计学意义(P<0.05)。椎间盘位置的分布存在显著差异,髁突位置和髁突形态在椎间盘形态中(P<0.05),与椎间盘位置呈正相关(r=0.703,P=0.000),髁突评分(r=0.478,P=0.000)和椎间盘形态评分。髁突形态间椎间盘位置和髁突位置的分布差异有统计学意义(P<0.05)。椎间盘位置与髁突形态呈正相关(r=0.413,P=0.000),髁突位置与髁突形态呈负相关(r=-0.152,P=0.000)。髁突间椎间盘位置分布差异有统计学意义(P<0.05),但无线性相关(P=0.159)。
结论:椎间盘形态的相互分布,圆盘位置,髁突形态和髁突位置有统计学意义。椎间盘移位不一定导致髁突骨骼变化,但92.7%的有髁突异常的TMJ有椎间盘移位。
背景:本研究于2022年3月28日进行了回顾性注册,并得到了伦理委员会的认可(LCYJ2022014)。
BACKGROUND: The authors retrospectively studied the relationship between the morphology and position of the articular disc in magnetic resonance imaging (MRI) and the morphology and position of the condyle in cone beam computed tomography (CBCT), with the purpose for providing reference for clinical diagnosis and treatment of temporomandibular disorders (TMD).
METHODS: Patients with both CBCT and MRI imaging data were studied retrospectively, excluding TMJ tumour, fracture, severe condylar morphological abnormalities, non-intercuspal position, and poor quality images. A total of 744 temporomandibular joints (TMJs) from 372 patients were included, with the mean age of 25.94±11.04Y (75 males and 297 females). T2-weighted image (T2WI) of MRI imagings were used to evaluate disc morphology and disc displacement, while CBCT was obtained to evaluate the condylar bone and sagittal condylar position. Data were analysed by Pearson Chi square test and Spearman correlation coefficient.
RESULTS: THE DISTRIBUTION OF 744 TMJS IS AS FOLLOWS: 1) DISC MORPHOLOGY: contracture (37.1 %) > biconcave (32.9 %) > irregular (18.5 %) > lengthened (11.4 %); 2) disc position: ADDWoR (48.3 %) > NA (26.9 %) > ADDWR (21.6 %) > PDDWR (2.8 %) > PDDWoR (0.4 %); 3) condylar position: concentric (43.7 %) > posterior (37.6 %) > anterior (18.7 %); 4) condylar bone: normal (63.4 %)> abnormal (36.6 %). There were significant differences in the distribution of disc morphology and disc position between the sex (P < 0.05). There were significant differences in the distribution of disc position and condylar morphology amongst the age groups (P < 0.05). There were significant differences in the distribution of disc position, condylar position and condylar morphology amongst disc morphology (P < 0.05), and there were positive correlation between disc position(r = 0.703, P = 0.000), the score of condyle (r = 0.478, P = 0.000) and disc morphology respectively. There were significant differences in the distribution of disc position and condylar position amongst condylar morphology (P < 0.05). There was a positive correlation between disc position and condyle morphology (r = 0.413, P = 0.000), and a negative correlation between condyle position and condyle morphology (r=-0.152, P = 0.000). There were significant differences in the distribution of disc position amongst condylar position (P < 0.05), but there was no linear correlation (P = 0.159).
CONCLUSIONS: The mutual distribution of disc morphology, disc position, condylar morphology and condylar position was statistically significant. Disc displacement did not necessarily lead to condylar bone changes, but 92.7 % TMJs with condylar bone abnormalities had disc displacement.
BACKGROUND: This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).