中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (1): 46-50.doi: 10.19438/j.cjoms.2017.01.010

• 论著 • 上一篇    下一篇

171例颞下颌关节滑膜软骨瘤病MRI分析

韩孜祥1, 陈敏洁1, 杨驰1, 魏文斌1, 石慧敏2   

  1. 1.上海交通大学医学院附属第九人民医院·口腔医学院 口腔外科,上海市口腔医学重点实验室,上海 200011;
    2.上海交通大学医学院附属第九人民医院 放射科,上海 200011
  • 出版日期:2017-01-20 发布日期:2017-02-27
  • 通讯作者: 陈敏洁,E-mail：chenminjie00@126.com
  • 作者简介:韩孜祥（1989-）,男,硕士研究生,E-mail：1195397571@qq.com
  • 基金资助:
    上海市科学技术委员会科研计划项目（14411960800,14DZ2294300）; 上海交通大学医工交叉项目（YG2013MS59）

Analysis of magnetic resonance imaging of 171 patients with synovial chondromatosis in the temporomandibular joint

HAN Zi-xiang1, CHEN Min-jie1, YANG Chi1, WEI Wen-bin1, SHI Hui-min2   

  1. 1.Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011;
    2.Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Online:2017-01-20 Published:2017-02-27

被引次数

1

摘要： 目的 通过分析颞下颌关节滑膜软骨瘤病（synovial chondromatosis, SC）的磁共振成像（magnetic resonance imaging, MRI）特点,对其在MRI影像上进行分型,并通过MRI影像探讨其潜在侵袭性。方法 收集2004年4月—2015年12月间治疗的171例颞下颌关节滑膜软骨瘤病患者的MRI影像资料。依据MRI特点,将瘤体分为游离体型、均质型以及混合型;依据骨质破坏程度分为无侵袭期、软骨破坏期、骨吸收期以及骨穿孔期,对两者关系以及术中所见进行对比分析。应用SAS 16.2软件包对数据进行χ2检验或Fisher检验。结果 游离体型患者55例（32.16%）,均质型84例（49.12%）,混合型32例（18.71%）。术中所见,70例（40.94%）有关节窝骨质破坏,而MRI无法识别软骨破坏期。14例骨穿孔期患者中,11例（78.57%）属于均质型,3例（21.43%）属于混合型;与无侵袭期患者相比,存在显著差异（P=0.009）。2例患者复发,均为均质型。结论 在MRI影像上,均质型和混合型滑膜软骨瘤病更具有侵袭性,应行滑膜切除术,甚至部分截骨术。

关键词: 滑膜软骨瘤病, 颞下颌关节, MRI, 分类, 骨质破坏

Abstract: PURPOSE: To evaluate the classification and potential aggressive behavior of temporomandibular joint (TMJ) synovial chondromatosis(SC) on magnetic resonance imaging by analyzing its MRI characteristics. METHODS: MRI data of 171 patients who suffered from synovial chondromatosis of TMJ treated in our hospital during April 2004 to December 2015 were collected. On the basis of MRI findings, there were three categories: type of loose body, type of homogeneous mass and type of mixture of both loose body and homogeneous mass. The MRI findings of bony erosion included 4 stages: without erosion, chondral destruction, bony absorption and bony perforation. The relationship between categories and bony erosion and the differences between bony erosion on MRI and surgical findings were analyzed. Chi-square test or Fisher's exact test was performed using SAS 16.2 software package. RESULTS: Type of loose body include 55 cases (32.16%), type of homogeneous mass include 84 cases (49.12%) and type of mixture include 32 cases (18.71%). According to surgical findings, 70 cases (40.94%) had bony erosion; however, MRI could not distinguish the stage of chondral destruction. Among 14 cases with bony perforation, 11 (78.57%) belonged to the type of homogeneous mass, 3 (21.43%) belonged to the type of mixture; compared to the stage without erosion, there was significant difference (P=0.009). Among all patients, 2 had recurrence. CONCLUSIONS: Synovial chondromatosis with the type of homogeneous mass and type of mixture on MRI were more aggressive. Patients with these types needs synovium removal, even partial osteotomy.

Key words: Synovial chondromatosis, Temporomandibular joint, MRI, Classification, Bony erosion

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