M Ercüment ÖNDER, Hakan H TÜZ, Reha Ş KİŞNİŞCİ, İbrahim Tanzer SANCAK

Temporomandibuler Eklem Manyetik Rezonans Görüntülerinde Efüzyonun Değerlendirilmesi

Temporomandibuler eklem manyetik rezonans görüntüleme MRG tekniği, disk pozisyonu ve dejenerasyonları gibi eklem içi yumuşak doku patolojilerini detaylı olarak gösteren ve sıklıkla kullanılan değerli bir görüntüleme tekniğidir. Bununla birlikte sinoviyal sıvı hakkında da detaylı bilgiler vermektedir. T2 ağırlıklı MRG’lerde artmış sinyal yoğunluğu efüzyon olarak adlandırılır.Çift kör, prospektif olarak gerçekleştiren bu çalışmaya 122 hastanın 243 eklemi dâhil edilmiştir. 243 eklemin MR görüntüleri, klinik bulgu ve belirtileri konusunda hiçbir bilgiye sahip olmayan bir radyolog tarafından efüzyon açısından değerlendirildi. Efüzyona sahip olmayan eklemler “0”, eklem yüzeyinde çizgisel yüksek yoğunluğa sahip eklemler “1”, alt ve üst eklem boşluklarını ve retrodiskal dokuları da içeren noktasal yoğunluğa sahip eklemler ise “2” olarak değerlendirildi. Efüzyon ile ağrı ve redüksiyonsuz disk deplasmanı arasında istatistiksel olarak bir korelasyon tespit edilmiştir. Efüzyon tespit edilen vakalarda hekimin, TME patolojisinin artık erken evrede olmayabileceği, enflamatuar prosesin halen devam eden bir süreçte bulunduğu bilinciyle tedavisini şekillendirmesi gerekmektedir

Anahtar Kelimeler:

Efüzyon, TMD, Dejenerasyon

The Evaluation of Effusion in Magnetic Resonance Images of Temporomandibular Joints

Magnetic resonance imaging MRI is one of the most reliable and frequently used method to determine soft tissue changes of temporomandibular joints TMJ such as disc position and degeneration. Also MRI can provide quantitative information about synovial fluid. Increased signal intensity in the T2-weighted MR images is called as effusion.This double blinded prospective clinical, study was undertaken in 243 joints of 122 patients 104 females, 18 males . MR images of these 243 joints were evaluated for the presence of effusion by a radiologist who had no information about the clinical data of the patients. Presence of effusion was recorded as “0” no effusion, “1” linear high density on joint surface, “2” high density including upper and lower joint spaces and retrodiscal tissues.We found that there were significant correlation between effusion and pain and disc displacement without reduction.The clinicians should design the therapeutic modalities knowing that the inflammatory processes are ongoing and that pathologic events in the TMJ, might not be in early phases any more, in cases with effusion

Keywords:

Effusion, TMD, Degeneration,

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