颞下颌关节盘MRI和锥形束CT图像配准的初步研究

来源 :中华口腔医学杂志 | 被引量 : 0次 | 上传用户:peibinggu123
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目的:建立颞下颌关节(temporomandibular joint,TMJ)的MRI和锥形束CT图像配准方法,并运用配准后的图像对关节盘与髁突位置关系进行初步评估。方法:纳入2018年1至3月就诊于武汉大学口腔医学院颞下颌关节门诊的3例颞下颌关节盘移位患者(共6侧TMJ),男性1例30岁,女性2例,分别为21和26岁。使用Mimics软件分别重建TMJ锥形束CT与MRI三维图像并进行配准,评价配准后的图像,并依次测量3例患者在开口、闭口状态下关节盘面积和体积,关节盘的位置即髁突最高点(C点)到关节盘中心点(D点)的距离、关节盘后带最后点(P点)到C点的距离以及线段CD与眶耳平面的夹角(∠DCF)。结果:3例患者的12幅TMJ的配准图像均可显示关节盘、关节结节、关节窝、髁突等解剖结构及相互关系。结合临床诊断,关节盘位置正常的CD差值最小(1.94 mm),不可复性盘前移位CD差值较小,可复性盘前移位CD差值较大;而不可复性盘前移位PC差值较小;关节盘正常开口位时,∠DCF角度最小为3.81°。而不可复性盘前移位其∠DCF角度最大为48.03°。结论:图像配准融合后可准确地显示患者闭口、开口时关节盘相对髁突的位置。开、闭口位CD差值大小对判断关节盘位置有一定意义,PC值可判断关节盘后带相对于髁突的位置。配准图像可从三维角度全面认识关节盘在不同状态下的形态和位置,并为颞下颌关节盘移位的临床研究提供了数据参考。“,”Objective:To evaluate the MRI and cone beam CT (CBCT) image registration methods of the temporomandibular joint (TMJ), and to explore the clinical application of the registered images and clinical diagnostic data for examining the relationship between the articular disc and condyle.Methods:Three patients with TMJ disc disposition were recruited at the Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University from January to March 2018. One patient was male, aged 30, and the others were females, aged 21 and 26 respectively. Three-dimensional (3D) images of CBCT and MRI of the TMJ were reconstructed and registered by using Mimics software. The images were then evaluated after the registration. The evaluation indicators selected were the area and volume of the articular disc, the position of the articular disc or the distance between the highest point of the condyle (point C) to the center point of the articular disc (point D), the distance between the last point of the joint disc (point P) to point C, as well as the angle between line CD and FH plane (∠DCF) at either opened- or closed-mouth condition.Results:The registration images of TMJ, at the closed- and opened-mouth positions of the 3 patients, showed the anatomical structures and interrelationships of the articular disc, articular nodules, joint fossa and condyle. Combined with clinical diagnosis, the difference of CD distances at the normal articular disc position was the minimum (1.94 mm), the difference of CD distances was small at the anterior disc displacement with non-reduction and larger with reduction. When the joint disc was in the opened-mouth position, ∠DCF angle was minimal (3.81°). The patients with anterior disc displacement with non-reduction showed the largest ∠DCF angle (48.03°).Conclusions:The position of the articular disc relative to the condyle and articular nodules, either at closed- or opened-mouth conditionds, could be accurately displayed after the image registration and fusion. The registration image not only could fully show the shape and position of the articular disc in different status from a 3D perspective, but also might provide basis for clinical study of TMJ disc displacement.
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