目的 通过盘-髁复合体磁共振成像(magnetic resonance imaging,MRI)特征分析及盘周附着半量化评级法,探讨颞下颌关节可复性盘前移位(anterior disc displacement with reduction,ADDWR)与不可复性盘前移位(anterior disc displacement without reduction,ADDWoR)中关节盘形态、髁突形态及盘周附着处之间的相关性.材料与方法 回顾性分析2021年5月至2022年9月于福建省级机关医院行MRI检查确诊为颞下颌关节盘前移位74例患者共114侧,分为ADDWR组39侧和ADDWoR组75侧,比较关节盘形态Ⅰ～Ⅳ类型、髁突形态3类别及盘周附着处半量化评分分级6级.采用Kruskal-Wallis检验比较两组中不同关节盘形态类型、髁突形态类别及盘周附着分级之间差异.采用Mann-Whitney U检验比较两组之间关节盘形态、髁突形态、盘周附着处总评分及各处附着评分差异.采用Spearman秩相关分析关节盘形态、髁突形态、盘周附着处总评分及各附着与盘-髁复合体可复性与否的相关系数.采用二元logistic回归方法对盘周附着的模型筛选出独立危险因素,作为盘-髁复合体是否可复性的预测.结果 除Ⅲ型与Ⅳ型外,两组关节盘形态类型差异均有统计学意义(P<0.05).两组髁突形态类别差异均有统计学意义(P<0.05).除1级至4级、5级/6级外,两组盘周附着评分分级差异均有统计学意义(P<0.05).关节盘可复性与否和关节盘形态、髁突形态及盘周附着处总评分存在较强的正相关性(r分别为0.824,0.626及0.827,P<0.05).盘周附着处的logistic回归预测模型筛选发现下板附着处是关节盘可复性与否的独立危险因素,回归系数为2.979(OR=19.672,P<0.05).结论 基于盘-髁复合体MRI征象分析及半量化评级法,能有效地评估关节盘可复性与否的相关性因素,为临床治疗提供可靠的影像学参考.
Study on MRI features of disc-condylar complex and semiquantitative evaluation of peridisc attachment in cases of temporomandibular joint disc displacement
Objective:To investigate the relationship of peridisc attachment to articular disk and condylar morphology in anterior disc displacement with reduction(ADDWR)and anterior disc displacement without reduction(ADDWoR)by analyzing the magnetic resonance imaging(MRI)features of disc-condylar complex and semi-quantitative grading method of peridiscal attachment.Materials and Methods:Retrospective analysis of 74 patients(114 sides)were diagnosed with anterior disc displacement of temporomandibular joint by MRI scan at the Department of Radiology of Fujian Provincial Hospital from May 2021 to September 2022.They were divided into reduction(39 sides)and non-reduction(75 sides)groups.Joint disk morphology were divided into four types(Ⅰ-Ⅳ),condylar morphology into three types and peridisc attachment into six grades.The Kruskal-Wallis test was employed to compare the difference of joint disk morphology,condylar morphology and peridisc attachment between the two groups.The Mann-Whitney U test was used compare the overall and attachment scores of joint disk morphology,condylar morphology and peridisc attachment.Spearman rank correlation analysis was used to compare the overall score of joint disk morphology,condylar morphology and peridisc attachment,as well as the correlation coefficient of attachment and joint disk-condylar complex reducibility.Binary logistic regression was adopted to choose the independent risk factors from peridisc attachment models to predict the joint disk-condylar complex reducibility.Results:Except type Ⅲ and type Ⅳ,joint disk morphology difference presented statistical significance(P<0.05).Condylar morphology difference presented statistical significance(P<0.05).Except grade 1 to 4,grade 5/grade 6,peridisc attachment grading difference presented statistical significance(P<0.05).Reduction of articular disk was strongly positively correlated to articular disk morphology,condylar morphology and total values of peridisc attachment(r=0.824,0.626,0.827,P<0.05).The prediction model of peridisc attachment showed that the lowerbilaminar region attachment was an independent risk factor for articular disc reduction with regression coefficient being 2.979(OR=19.672,P<0.05).Conclusions:By analyzing MRI features of disc-condylar complex and the proposed semi-quantitative evaluation,factors affecting articular disc reduction are effectively evaluated,which provides reliable imaging reference for clinical treatment.
万方数据
维普
