Internal Derangement of the Temporomandibular Joint: Correlation between MRI and Clinical Findings

顳顎關節內錯位：評估磁振造影與臨床發現之關聯

彭信逢(Steven Shinn-Forng Peng) ； 廖漢文(Hon-Man Liu) ； 蕭裕源(Yuh-Yuan Shiau) ； 徐劍耀(Jane Chien-Yao Hsu) ； 黃國茂(Kou-Mou Huang)

《慈濟醫學雜誌》 10卷1期 (1998/03) Pp. 29-36

https://doi.org/10.6440/TZUCMJ.199803.0029

摘要

內錯位是顳顎關節病患常見的關節變化;尤其除了關節半月軟骨的前移位之外，側向以及旋轉移位並不少見。雙側顳顎關節內錯位也經常發生。本研究蒐集四十位顳顎關節有症狀的病患，完成了七十九個顳顎關節的磁振造影檢查;包括以幾種脈序: 1)斜位矢向切面自旋回波、T1加重影像於張口及閉口姿勢，共七十九個關節受檢，2)斜位矢向切面多平面梯度回音影像於張口姿勢，共四十三個關節受檢，3)斜位冠向切面自旋回波T1加動影像於閉口姿勢，共六十五個關節受檢。雙側斜位矢向冠向面自旋回波、T1加重影像，共二十五位病患受檢。冠向切面影像分析的加入，有一個關節原本矢向面像診斷為正常，但冠向切面則可見關節半月軟骨的向內移位，因有十五個矢向切面診斷為前移位者，冠向面可顯示為旋轉移位。接受雙側顳顎關節檢查的二十五位病患中有十六位有雙側半月軟骨移位。而半月軟骨變形者較不易於張口時復位。關節雜音較多見於半月軟骨運動性減低但顎關節突運動性正常或增加的病患。本研究顯示將斜位冠向切面列入常規檢查有助於偵測到旋轉移位，而常見的雙側內側位則可以使用顳顎關節雙表面線圈檢查較適合。(慈濟醫學1998;10:29-36)

關鍵字

磁振造影 ； 內錯位 ； 顳顎關節

並列摘要

In patients suffering from internal derangement of temporomandibular joint (TMJ), both sideways and rotational displacement of the TMJ menisci are common, and most cases have bilateral involvement. The purpose of this study was to evaluate the value of bilateral cornal images of TMJs in patients suspected of internal derangement. Seventy-nine TMJs in totally 40 patients were studied using magnetic resonance imaging techniques including: 1) oblique sagittal, T1-weighted spin echo images in the closed-and opened-mouth positions in 79 TMJs; 2) oblique sagittal, multiplanar gradient recalled images in the closed-mouth projection in 43 TMJs; 3) oblique coronal, spin echo, T1-weighted images in the closed-mouth position in 65 TMJs. Bilateral coronal and sagittal images in the closed-and opened-mouth positions were obtained in 25 patients. With the additional use of oblique coronal images, the diagnosis changed from normal to abnormal in one joint and from anterior displacement to rotational displacement in TMJs. Bilateral TMJs were involved with internal derangement in 16 of 25 patients. Joint clicking was significantly more common in patients with less mobile menisci overlying mandibular condyles with normal or increased mobility. Our results indicated routine use of oblique coronal images is valuable in the detection of rotational and sidweways displacement. Use of a dual TMJ surface coil is suitable for detection of bilaterally displaced menisci.(Tzu Chi Med J1998;10:29-36)

並列關鍵字

magnetic resonance imaging ； internal derangement ； temporomandibular joint