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目的 :评价X线平片造影对颞下颌关节上腔囊内粘连的诊断价值。方法 :选取临床诊断为关节内错乱患者 10 5例 ( 10 5侧 ) ,进行关节上腔平片造影及关节镜检查。按平片造影影像学诊断标准 ,确定有无粘连 ,分阳性组、可疑组及阴性组 ;并与关节镜诊断结果对比 ,得出真、假阳性 ,真、假阴性例数 ,应用SPSS软件制作ROC曲线 ,计算ROC曲线下面积。同时分析漏诊、误诊的原因。结果 :关节镜诊断囊内粘连为 5 3 .3 3 % ( 5 6/ 10 5 )。平片造影诊断与关节镜诊断对照 :阳性组 40例 ,其中 3 2例真阳性 ,8例假阳性 ;可疑组 18例 ,其中 9例真阳性 ,9例假阳性 ;阴性组 47例 ,3 2例真阴性 ,15例假阴性。造影易检出的粘连部位是外中份 ;易漏诊的部位是内 1/ 3 ;粗大粘连带易于检出。ROC曲线下面积为 0 .73 ( 0 .64 ,0 .82 ) ,P <0 .0 5。结论 :X线平片造影对诊断囊内粘连的整体准确性中等 ,但不失为一种简单、实用的影像学检查方法 ,其漏诊的主要原因与粘连带的大小和部位有关。
OBJECTIVE: To evaluate the diagnostic value of plain radiography in the diagnosis of adhesion in the superior temporomandibular joint. Methods: One hundred and five patients (105 sides) with clinically diagnosed intra-articular derangement were enrolled in this study. The upper compartment radiography and arthroscopy were performed. According to the diagnostic criteria of plain radiography, determine the presence or absence of adhesion, sub-positive group, suspicious group and negative group; and compared with the results of arthroscopy, the number of true, false positive, true and false negatives was obtained, and SPSS software was used ROC curve, calculate the area under the ROC curve. At the same time analysis of missed diagnosis, misdiagnosis reasons. Results: Arthroscopic diagnosis of intracapsular adhesions was 53.3% (56/105). In the positive group, 40 cases were positive, of which 32 cases were true positive and 8 cases were false positive; 18 cases were suspicious, of which 9 cases were true positive and 9 cases were false positive; 47 cases were negative and 32 cases were true Negative, 15 false negatives. Easily detect the adhesion site is outside the medium contrast; easy to miss the site is 1/3; coarse adhesive tape easy to detect. The area under the ROC curve was 0.73 (0.64, 0.82), P <0. 05. CONCLUSION: X-ray plain imaging is a medium-sized method for the diagnosis of intra-capsular adhesions. However, it is a simple and practical method for imaging examination. The main reason for missed diagnosis is related to the size and location of the adhesive band.