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目的对颞下颌关节(TMJ)开闭口位计算机曲面断层摄影(COPT)与薛氏位(SR)、胶片曲面断层摄影(FOPT)进行对比研究,探讨 COPT 的优势。方法对98例患者分组并分别采用双侧 TMJ 开闭口位 COPT、FOPT、SR 等3种摄影技术进行摄影检查,对图像所显示的各解剖结构满意率采用 Pearson 卡方检验,对各组满意率两两比较采用 q 检验进行统计学分析。结果 144幅 COPT、128幅 FOPT 和120幅 SR 摄取的 TMJ 开闭口位图像显示的下颌支满意幅数分别为144、128、6,满意率分别为100%、100%、5%(P<0.01);冠突显示满意幅数分别为144、128、12,满意率分别为100%、100%、10%(P<0.01);切迹显示满意幅数分别为144、128、66,满意率分别为100%、100%、55%(P<0.01);关节间隙显示满意幅数分别为96、89、120,满意率分别为75%、62%、100%(P<0.01);对髁突、关节结节显示满意幅数分别为144、128、120,满意率均为100%。下颌支、冠突、切迹、关节间隙显示满意率3种摄影方法两两比较,SR与FOPT间比较,差异有统计学意义(P 值均<0.01);SR 与COPT 间比较(P 值均<0.01),差异有统计学意义;FOPT 与 COPT 间比较,差异无统计学意义(P 值均>0.05)。双侧 TMJ 开闭口位3种摄影技术曝光量分别为 COPT 99～113 mAs、FOPT 210～225 mAs、SR 210～500 mAs。因此,COPT、FOPT 对下颌支、冠突、切迹的显示质量优于 SR,对关节间隙的显示不及 SR,对髁突、关节结节显示三者相同,SR 曝光量大于 COPT 和 FOPT,FOPT 大于 COPT。结论COPT 检查颞下颌关节开闭口位,优于 FOPT 及 SR 摄影技术,应该在临床中推广应用。
Objective To compare the advantages and disadvantages of COPT with Schrödinger’s position (SR) and film surface tomography (FOPT) at the opening and closing mouth of temporomandibular joint (TMJ). Methods 98 patients were divided into two groups and were examined by bilateral TMJ mouth opening and closing portography COPT, FOPT, SR and other three kinds of photography. The satisfaction rate of each anatomical structure showed by image was analyzed by Pearson-Chi-square test, Pairwise comparisons using q test for statistical analysis. Results The satisfaction rate of mandibular branch in 144 COPT, 128 FOPT and 120 SR images was 100%, 100% and 5% respectively (P <0.01) ). The satisfactory amplitude of the coronoid process was 144,128,12 and the satisfaction rates were 100%, 100% and 10%, respectively (P <0.01). The satisfactory amplitude of notch showed 144, 128 and 66 respectively (100%, 100%, 55%, respectively) (P <0.01). The joint gap showed a satisfactory amplitude of 96, 89 and 120, respectively, and the satisfaction rates were 75%, 62% and 100% Suddenly, joint nodules showed satisfactory amplitude 144,128,120, satisfaction rate was 100%. There was significant difference between SR and FOPT (P <0.01). There was no significant difference between SR and COPT (P value <0.01). The difference was statistically significant. There was no significant difference between FOPT and COPT (P> 0.05). The exposures of the three kinds of TMJ opening and closing ports at bilateral TMJ were 99 ~ 113 mAs of COPT, 210 ~ 225 mAs of FOPT and 210 ~ 500 mAs of SR. Therefore, the quality of presentation of mandibular branch, coronoid process and notch was better than that of SR, and the display of joint space was not as good as that of SR. The condyle and joint nodules showed the same three, and the SR exposure was larger than that of COPT and FOPT Greater than COPT. Conclusion COPT examination of temporomandibular joint opening and closing mouth position, better than FOPT and SR photography, should be widely used in clinical practice.