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中华口腔医学研究杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 174 -179. doi: 10.3877/cma.j.issn.1674-1366.2019.03.007

所属专题： 文献；

临床研究

颞下颌关节滑膜软骨瘤病的临床及影像学特征分析
苏凯1, 欧发荣1, 张志光1, 郑有华1,†()   
  1. 1. 中山大学光华口腔医学院·附属口腔医院，广东省口腔医学重点实验室，广州　510055
  • 收稿日期:2019-01-11 出版日期:2019-06-01
  • 通信作者: 郑有华

Analysis of clinical and imaging characteristics of synovial chondromatosis of temporomandibular joint

Kai Su1, Farong Ou1, Zhiguang Zhang1, Youhua Zheng1,†()   

  1. 1. Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2019-01-11 Published:2019-06-01
  • Corresponding author: Youhua Zheng
  • About author:
    Corresponding author: Zheng Youhua, Email:
  • Supported by:
    Natural Science Foundation of Guangdong Province(2018A0313726)
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引用本文：

苏凯, 欧发荣, 张志光, 郑有华. 颞下颌关节滑膜软骨瘤病的临床及影像学特征分析[J]. 中华口腔医学研究杂志(电子版), 2019, 13(03): 174-179.

Kai Su, Farong Ou, Zhiguang Zhang, Youhua Zheng. Analysis of clinical and imaging characteristics of synovial chondromatosis of temporomandibular joint[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(03): 174-179.

目的

研究人颞下颌关节滑膜软骨瘤病的临床及影像特征，为通过锥形束CT（CBCT）造影检查提供诊断依据。

方法

采用回顾性研究1998年6月至2015年7月在中山大学附属口腔医院收治的21例组织病理学上诊断为滑膜软骨瘤病的患者，对其临床表现、影像检查、手术治疗、组织病理学特征等进行研究，对其CBCT造影检查的特征进行概括总结。

结果

颞下颌关节滑膜软骨瘤病多发生在女性，主要症状包括关节区肿胀、关节杂音、关节周围疼痛、张口受限等。CBCT造影检查可检测出关节腔内的软骨小体。滑膜软骨瘤病主要发生于关节上腔，同时也可发生于关节下腔，而CBCT造影检查可轻易检测出病变有无合并关节盘的穿孔。

结论

CBCT造影检查在滑膜软骨瘤病关节腔中可见特征性的类圆形缺损，其对关节滑膜软骨瘤病的诊断有重要帮助。

关键词: 颞下颌关节, 软骨瘤病，滑膜, 锥束计算机体层摄影术
Objective

To study the clinical and radiologic findings of synovial chondromatosis (SC) and provide a reference for its radiologic diagnosis by using cone-beam computed tomography (CBCT) arthrography.

Methods

Twenty-one patients presenting to our clinic with SC diagnosed histopathologically were included in the study. The clinical manifestations, radiographic findings, surgical treatment, and histopathologic features of the disease were investigated. The features of SC of the temporomandibular joint (TMJ) on CBCT arthrography were summarized.

Results

SC of the TMJ occurred more often in women. Its main symptoms included swelling, crepitations, preauricular pain, and limitation of mandibular movement. The detection rate of calcified loose bodies was 100% on CBCT arthrography. SC mainly affected the superior joint space and could involve the inferior space through a perforated disc and could be easily detected with CBCT arthrography.

Conclusions

The characteristic round-like filling defect of SC of the TMJ could be easily detected on CBCT arthrography images. Therefore, CBCT arthrography with contrast medium injection plays an important role in the diagnosis of SC.

Key words: Temporomandibular joint, Chondromatosis, synovial, Cone-beam computed tomography
图5 颞下颌关节滑膜软骨瘤病的开放手术治疗　5A：左侧颞下颌关节腔经耳屏缘切口暴露，可见大量或大或小的白色钙化软骨小体；5B：刮除的大量软骨小体
图12 术后标本：大量白色质韧软骨样小体
图15 术后标本　可见3颗软骨样肿物
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