3T 磁共振成像上模仿颞下颌关节疾病的头颈部关节外疾病的患病率和临床症状

Yusuke Kawashima, Aya Hagimoto, Hiroshi Abe, Masaaki Miyakoshi, Yoshihiro Kawabata, Hiroko Indo, Tatsuro Tanaka
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摘要

很少有研究报道关节外疾病的患病率以及这些疾病的临床症状和颞下颌关节(TMJ)磁共振成像(MRI)检查结果,而这些检查结果与真正的颞下颌关节疾病(TMD)无关。因此,我们旨在确定在 3 特斯拉 (3T) 磁共振成像上模仿真正 TMD 的头颈部关节外疾病的患病率和临床症状。这项研究纳入了 100 名临床诊断为 TMD 并接受 TMJ 磁共振成像检查的患者。我们使用轴向迪克森 T2 加权成像(T2WI)记录了头颈部信号强度异常的病变。三位患者(三位男性,平均年龄 44.3 岁)的头颈部有异常高信号强度的病变。三名患者(三名男性,平均年龄 44.3 岁)的头颈部均有异常高信号强度的病变,临床症状均为肢体瘫痪。病变位置如下:左侧翼内肌和翼外肌,右侧腮腺深叶,左侧下颌骨体。在到医院就诊的患者中,有 3% 的患者患有关节外疾病,并伴有真正的 TMD 症状。眩晕可能是表明存在关节外疾病的主要临床症状,需要进一步进行临床或影像学检查。
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Prevalence rate and clinical symptom of extra‐articular diseases of the head and neck region mimicking temporomandibular disorders on 3T MRI
Few studies have reported on the prevalence rate of extra‐articular diseases and on the clinical symptom and temporomandibular joint (TMJ) magnetic resonance imaging (MRI) findings that are seen in these diseases and are not related to genuine temporomandibular joint disorders (TMDs). Therefore, we aimed to determine the prevalence rate and clinical symptom of extra‐articular diseases of the head and neck region that mimic genuine TMDs on 3‐tesla (3T) MRI.This study included 100 patients who were clinically diagnosed with TMDs and underwent TMJ MRI. We recorded lesions with abnormal signal intensities in the head and neck region using axial Dixon T2‐weighted imaging (T2WI). The clinical symptoms of the patients and pathology of extra‐articular diseases were determined based on medical records.Three patients (three males; mean age, 44.3 years) had lesions with abnormal high signal intensity in the head and neck region. All three patients presented with trismus as a clinical symptom. The locations of the lesions were as follows: the left medial and lateral pterygoid muscles, deep lobe of the right parotid gland, and body of the left mandible. Two patients had malignancies.Among the patients who visited the hospital, 3% had extra‐articular diseases and presented with genuine TMD symptom. Trismus may be a key clinical symptom indicating the presence of extra‐articular diseases and need for further clinical or imaging examinations.
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