上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (6): 641-646.doi: 10.19439/j.sjos.2025.06.015

• 论著 • 上一篇    下一篇

磁共振成像在颞下颌关节退行性关节病诊断中的效果评价

刘莎莎1,2, 徐丽丽1,2, 毛梦莹1, 陆沈吉1,2, 朱凌3,*, 蔡斌1,*   

  1. 1.上海交通大学医学院附属第九人民医院 康复医学科, 上海 200011;
    2.上海市松江区泗泾医院 康复医学科, 上海 201601;
    3.上海交通大学医学院附属第九人民医院 医学影像科, 上海 200011
  • 收稿日期:2024-06-25 修回日期:2024-11-06 发布日期:2025-12-30
  • 通讯作者: 蔡斌,E-mail: shrehab@163.com;朱凌,E-mail: zhul1797@sh9hospital.org.cn。*共同通信作者
  • 作者简介:刘莎莎（1988-）,女,博士,主治医师,E-mail: 609760735@qq.com
  • 基金资助:
    上海市卫生健康系统重点扶持学科计划（2023ZDFC0303）; 上海市科学技术委员会科研计划项目（21Y11903400）

Evaluation of magnetic resonance imaging in the diagnosis of temporomandibular degenerative joint disease

Liu Shasha1,2, Xu Lili1,2, Mao Mengying1, Lu Shenji1,2, Zhu Ling3, Cai Bin1   

  1. 1. Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    2. Department of Rehabilitation Medicine, Sijing Hospital of Songjiang District of Shanghai. Shanghai 201601;
    3. Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2024-06-25 Revised:2024-11-06 Published:2025-12-30

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摘要： 目的:评价磁共振成像（magnetic resonance imaging,MRI）在颞下颌关节退行性关节病（degenerative joint disease,DJD）诊断中的应用效果。方法:选择2019年6月—2021年6月期间在上海交通大学医学院附属第九人民医院颞下颌关节康复专科就诊的颞下颌关节紊乱病（temporomandibular joint disorder, TMD）患者152例,共304侧颞下颌关节,均行CBCT和MRI检查。以CBCT结果为参考标准,计算MRI对9种不同类型颞下颌关节骨质异常的敏感度、特异度和准确度。结果:MRI对髁突表面侵蚀、髁突骨赘形成、髁突骨质硬化、髁突皮质下囊性变、髁突形态扁平化、关节窝骨质侵蚀或硬化、关节窝骨质吸收或增生、关节间隙减小或融合以及关节间隙增大的敏感度分别为95.9%、81.0%、49.2%、81.3%、98.1%、76.7%、84.4%、52.8%和29.4%;特异度分别为49.4%、80.8%、83.7%、85.3%、52.5%、77.5%、78.1%、88.4%、98.3%;准确率分别为83.2%、80.9%、69.4%、84.9%、92.1%、77.3%、82.2%、76.0%和94.4%。结论:MRI对各型颞下颌关节骨质异常的诊断准确性均较高,可作为DJD的影像学筛查及诊断手段。

关键词: 磁共振成像, 锥形束CT, 退行性关节病, 颞下颌关节紊乱病

Abstract: PURPOSE: To evaluate the ability of magnetic resonance imaging(MRI) in diagnosis of degenerative joint disease (DJD). METHODS: A total of 152 patients with temporomandibular joint disorder(TMD) from June 2019 to June 2021 were included. A total of 304 temporomandibular joints(TMJs) were examined both by cone-beam CT (CBCT) and MRI. The sensitivity, specificity and accuracy of MRI for nine types of TMJ abnormalities were calculated with CBCT as gold standard. RESULTS: The sensitivity of MRI for condylar surface erosion, condylar osteophyte formation, condylar osteosclerosis, subcortical cystic degeneration, condylar flattening, fossa bone erosion or sclerosis, fossa bone absorption or proliferation, joint space reduction or fusion, and joint space increase, was 95.9%, 81.0%, 49.2%, 81.3%, 98.1%, 76.7%, 84.4%, 52.8%, and 29.4% respectively. The specificity was 49.4%, 80.8%, 83.7%, 85.3%, 52.5%, 77.5%, 78.1%, 88.4% and 98.3%, respectively. The accuracy was 83.2%, 80.9%, 69.4%, 84.9%, 92.1%, 77.3%, 82.2%, 76.0% and 94.4% respectively. CONCLUSIONS: MRI has high accuracy in the diagnosis of nine types of TMJ bone abnormalities. MRI is suitable for imaging screening and diagnosis of DJD.

Key words: MRI, Cone-beam CT, Degenerative joint disease, Temporomandibular joint disorder

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