摘要
目的:研究青少年颞下颌关节关节盘损伤对咀嚼肌结构变化的影响,以探讨MRI对颞下颌关节紊乱病(TMD)的诊断价值。方法:收集2019年4月至2020年12月于温州医科大学附属第二医院育英儿童医院行颞下颌关节MRI检查的42例患者为研究对象,所有患者均行3.0T颞下颌关节MRI检查,均通过常规序列图像诊断为单侧关节盘移位且对侧无移位;扫描T2-mapping及3D-CUBE T2序列,在T2-mapping序列上测量关节盘T2值,在3D-CUBE T2序列图像上行多平面重组测量翼内肌、翼外肌及咬肌3对咀嚼肌的横截面积及高度,并计算相对体积;使用配对t检验比较损伤侧与对照侧咀嚼肌的横截面积、高度及相对体积,采用配对t检验比较损伤侧与对照侧关节盘T2值,采用Pearson相关分析研究损伤侧与对照侧存在差异咀嚼肌的横截面积差值、高度差值及相对体积差值之间相关性,采用Pearson相关分析研究咀嚼肌的横截面积、高度及相对体积的损伤侧与对照侧的差值与关节盘T2值的差值之间的相关性。结果:损伤侧咬肌横截面[(412.66±106.40)mm^(2)]较对照侧[(435.60±99.28)mm^(2)]减小(P<0.05),损伤侧咬肌相对体积[(29.79±9.91)cm^(3)]较对照侧[(31.77±8.83)cm^(3)]减小(P<0.05);损伤侧关节盘T2值[(32.06±3.86)ms]较对照侧[(36.45±5.48)ms]减小(P<0.001)。损伤侧与对照侧咬肌横截面积差值与相对体积差值之间存在高度正相关(r=0.930,P<0.001)。结论:TMD患者健侧咬肌较患侧发达,推断TMD在出现症状之前可能产生不适致健侧咀嚼,健侧咬肌增粗增大可能是TMD的一个间接影像特征。
Objective:To study the effect of temporomandibular joint disc injury on masticatory muscle structure in adolescents,and to explore the diagnostic value of MRI in temporomandibular disorder(TMD).Methods:A total of 42 patients who received MRI examination of temporomandibular joint in the Second Affiliated Hospital﹠Yuying Children’s Hospital of Wenzhou Medical University from April 2019 to December 2020 were collected as research subjects.All patients underwent MRI examination of temporomandibular joint at 3.0T,and were diagnosed as unilateral disc displacement without contralateral displacement through routine sequence images.T2-mapping and 3D-CUBE T2 sequences were scanned.The joint disk T2 values were measured on the T2-mapping sequence.The cross-sectional area and the height of 3 pairs of masseters,i.e.internal pterygoid muscles,external pterygoid muscles and masseter muscles were measured by multiplane recombination on the 3DCUBE T2 sequence images,and their relative volume was calculated.Paired t test was used to compare the crosssectional area,height and relative volume of masticatory muscles as well as the T2 value between the injured side and the control side.Pearson correlation analysis was used to study the correlation among the cross-sectional area difference,height difference,and relative volume difference of masticatory muscles with differences between the injured and control sides.Pearson correlation was also used to analyze the correlation between the difference of the cross-sectional area,height and relative volume of the masticatory muscle on the injured side and the control side and the difference of the articular disk T2 value.Results:Compared with the control side[(435.60±99.28)mm^(2)],the cross section of masseter muscle on the injured side[(412.66±106.40)mm^(2)]decreased(P<0.05),and compared with the control side[(31.77±8.83)cm^(3)],the relative volume of masseter muscle on the injured side[(29.79±9.91)cm^(3)]decreased(P<0.05).The T2 value on the injured side[(32.06±3.86)ms]was lower than that on the control side[(36.45±5.48)ms](P<0.001).There was a high positive correlation between the difference in cross-sectional area and relative volume of the masseter muscle on the injured and control sides(r=0.930,P<0.001).Conclusion:The masseter muscle of the healthy side is more developed than that of the affected side in patients with TMD.It is inferred that the masseter muscle of the affected side may be an indirect imaging feature of TMD before symptoms appear.The enlarged masseter muscle on the affected side may be an indirect imaging feature of TMD.
作者
葛怀志
陈久尊
徐雷
赵周静
白光辉
GE Huaizhi;CHEN Jiuzun;XU Lei;ZHAO Zhoujing;BAI Guanghui(Department of Radiology,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China)
出处
《温州医科大学学报》
CAS
2023年第8期657-661,共5页
Journal of Wenzhou Medical University
基金
浙江省医药卫生科技计划项目(2023KY912)
温州市基础性科研项目(Y20211049)。
作者简介
葛怀志,主管技师,Email:gehuaizhi@wmu.edu.cn;通信作者:白光辉,副主任医师,Email:bghu79@126.com。
