악관절내장증환자의 악관절조영사진과 자기공명영상 소견의 비교

Comparision of arthrographic and mri findings on tmj internal derangement

The arthrographic and MRI findings of 44 joints suspected of having internal derangements were compared. MRI is markedly superior in detection of the changes in disc position and shape as compared to arthrography, especially the changes in the shape and the mediolateral dispalcement of the disc, which make it useful when the replacement of the disc is attempted. Furthermore, the osseous changes anterosuperior to the mandibular condyle can be visualized for the prediction of the progression of arthrosis. However, the preforation and adhesion of the disc and the retrodiscal tissue are yet to be successfully visualized asccurately on MRI. The arthrography has been used since the second half of the 1970s for the visualization of the internal derangements. The procedure can provide accurate informations concerning the anterior-posterior position and the reduction of the disc. However, the shape of the disc is not visualized, and the mediolateral displacement cannot be diagnosed accurately from the edge sign of the arthrography alone. Despite the shortcomings, the arthrograhy can still provide informations in the diagnosis of the disc perforations and the dynamics of the disc movements better than MRI. The procedure also provide some limited informations concerning the disc adhesion through the findings when the dye is being injected. The two procedures each have their own advantages and shortcomings. The decision to use which method may depend on the ease of the application in each case, and for the suspected condition further tests using the other method may yield more accurate diagnosis.