MRI分期与TMD临床症状相关性的分析

摘要/Abstract

摘要： 目的评估颞下颌关节紊乱病（temporomandibular disorder, TMD）磁共振成像（MRI）分期与临床症状的相关性。方法通过回顾性队列研究，收集2018年12月—2019年12月至我院颌面外科就诊的160例患者的基本信息、MRI影像、数据化测定（VAS）评分表以及张口度。将患者根据年龄分组（12~18、18~40、40~70岁），分析不同分期的TMD患者分布情况。分析患者性别与TMD分期的相关性，并分析TMD患者分期（Ⅱ~Ⅳ期）与VAS、最大张口度的相关性。对测量数据进行Wilcoxon秩和检验。结果 Ⅱ~Ⅴ期患者张口度分别为（31.22±9.40）、（20.77±6.51）、（29.39±5.81）和（22.41±9.18）mm，Ⅱ期与Ⅲ、Ⅴ期张口度有明显差异（P<0.05）；Ⅱ~Ⅴ期患者VAS评分为20.47±11.30、64.48±23.51、51.34±20.47和45.61±16.38，Ⅲ期与Ⅱ期比有统计学差异（P<0.05）。结论 MRI能够准确地反应TMD患者的盘-髁关系。基于MRI的TMD分期与TMD临床症状具有相关性。Ⅲ期患者疼痛症状最为明显，Ⅲ期及Ⅴ期患者张口受限较为明显。

关键词: 颞下颌关节紊乱病, 磁共振成像（MRI）, 数据化测定（VAS）

Abstract: Objective To evaluate the correlation between temporomandibular disorder (TMD) MRI staging and clinical symptoms. Methods Through a retrospective cohort study, basic information, MRI images, VAS score sheets, and mouth opening were collected from 160 patients attending maxillofacial surgery in our hospital from December 2018 to December 2019. Patients were divided into different age groups (12-18,18-40,40-70 years old). The distribution of TMD patients in different stages was analyzed. The correlation between patient gender and TMD staging, the correlation between TMD patient stage (stage Ⅱ-Ⅳ) and VAS, maximum opening degree were analyzed. SAS9.0 software package was used for Wilcoxon rank sum test. Results The opening degree of Ⅱ-Ⅳ patients was (31.22±9.40), (20.77±6.51), (29.39±5.81) and (22.41±9.18)mm respectively. There was a significant difference in opening degree between stage Ⅱ, stage Ⅲ and Ⅴ (P<0.05). The VAS scores of patients in Ⅱ-Ⅴ period were 20.47±11.30, 64.48±23.51, 51.34±20.47 and 45.61±16.38 respectively, and stage Ⅲ was statistically different from stage Ⅱ(P<0.05). Conclusion MRI can accurately reflect the relationship of the disc condyle in TMD patients. MRI staging has a correlation with TMD clinical symptoms. Patients in stage Ⅲ and Ⅴ have limited mouth opening, and patients in stage Ⅲ have obvious joint pain according to the MRI image of TMD patients.

Key words: temporomandibular joint disorder(TMD), MRI, VAS

中图分类号:

R782.6

何佳嘉丁水清周永强刘桂才陈建荣. MRI分期与TMD临床症状相关性的分析[J]. 口腔医学, 2021, 41(7): 631-634.

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