Internal Derangement of the Temporomandibular Joints: Magnetic Resonance Imaging Evaluations

顳顎關節內錯位：磁振造影之評估

藍顥章(Howard Haw-Chung Lan) ； 蔡志文(Jyh-Wen Chai) ； 李三剛(San-Kan Lee) ； 江志明(Chih-Ming Chiang)

《中華放射線醫學雜誌》 19卷1期 (1994/03) Pp. 25-32

摘要

顳顎關節內錯位是造成此關節疼痛或功能失常的主要原因之一，一般它是由於顳顎關節內半月狀軟骨向前內側移位所致。由於半月狀軟骨是x光可透性，故用一般x光片或電腦斷層不易診斷。使用關節腔攝影，可間接看到半月狀軟骨，以評估它在關節內運動情形而加以診斷，但這是一種侵害性的檢查。利用磁振造影，可直接看到半月狀軟骨而不具侵害性。我們把磁振造影觀察臨床懷疑顳顎關節內錯位的發現分成四級；即零級：半月狀軟骨的位置及形狀正常。一級A：半月狀軟骨前置但可回復，且形狀正常。一級B：半月狀軟骨前置且不能回復，但形狀正常。及二級：半月狀軟骨前置不能回復且變形。我們發現一級B及二級可診斷爲顳顎關節內錯位，而零級則非。至於一級A診斷較不易確定。因爲部分無症狀的病人，其顳顎關節也可表現一級A的情形。

關鍵字

顳顎關節 ； 關節磁振造影

並列摘要

Internal derangement (ID) of the temporomandibular joint (TMJ) is an important cause of TMJ dysfunction. It involves anteromedial displacement of the TMJ meniscus (disc) and is difficult to be evaluated with conventional radiographies or computed tomography. Arthrography proves to be valuable in evaluating TMJ-ID; however, it is an invasive procedure. Fifteen TMJs in 11 cases were examined with magnetic resonance images (MRI) and were grouped as (1) grade 0: normal disc position and morphology, (2) grade 1A: anterior disc position with reduction, in normal morphology, (3) grade 1B: anterior disc position without reduction, in normal morphology, and (4) grade 2: anterior disc position and deformity without reduction. Grade 1B and 2 TMJs correlated well with clinical symptoms and signs, and the diagnosis of TMJ-ID could be made. Grade 0 TMJ did not relate to TMJ-ID. The relationship between grade 1A and TMJ-ID was controversial. The diagnosis of TMJ-ID should be conservative and further studies might be necessary. We suggested that MRI was of value in evaluating TMJ-ID.

並列關鍵字

Joints, temporomandibular ； joints, MR