Diagnostic Value of Arthrography Combined Cone-beam Computed Tomography in Temporomandibular Joint Disc Perforation
10.11714/jsysu.med.YX20260094
- VernacularTitle:锥形束CT造影在颞下颌关节盘穿孔的诊断价值
- Author:
Yiqing HE
1
;
Jiahe CHEN
1
;
Yangpeng SUN
1
Author Information
1. Department of Oral and Maxillofacial Surgery//Guangdong Provincial Key Laboratory of Stomatology， Guanghua School and Hospital of Stomotology， Sun Yat-sen University， Guangzhou， 510055
- Publication Type:Journal Article
- Keywords:
temporomandibular joint;
osteoarthrosis;
disc perforation;
cone-beam computed tomography;
arthrography
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(5):880-885
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the diagnostic value of cone-beam computed tomography （CBCT） arthrography for temporomandibular joint disc perforation. MethodsA retrospective analysis was conducted on patients who were clinically diagnosed with temporomandibular joint osteoarthrosis （TMJOA） and underwent CBCT arthrography and open surgery between December 2013 and January 2023. The diagnostic results of CBCT arthrography were compared with the gold standard of open surgical exploration to determine the number of true and false positive and negative cases， thereby evaluating the overall accuracy of CBCT arthrography in diagnosing disc perforation. ResultsA total of 90 patients （106 joints） met the inclusion criteria of this study， including 10 males with an average age of 36.4 years and 80 females with an average age of 42.6 years. Among them， 74 joints exhibited unilateral lesions （82.22%）， and 16 joints exhibited bilateral lesions （17.78%）. Among these， 94 joints （88.68%） showed good contrast medium visualization， while 12 joints （11.32%） showed poor contrast medium visualization. CBCT arthrography clearly diagnosed disc perforation in 75 joints （70.75%）， and surgical exploration confirmed perforation in 75 joints. In 5 cases， poor contrast medium visualization was observed， and the imaging diagnosis suggested possible perforation， with surgical exploration confirming perforation in 5 cases； the true positive rate of imaging diagnosis was 100%. CBCT arthrography clearly diagnosed the absence of disc perforation in 19 joints （17.92%）， and surgical exploration confirmed the absence of perforation in 19 joints， with a true negative rate of 73.08%. In 7 cases， poor contrast medium visualization was observed， and the imaging results did not report disc perforation， but surgical exploration revealed perforation in 7 cases， with a false negative rate of 26.92%. ConclusionsCBCT arthrography demonstrates high diagnostic accuracy for temporomandibular joint disc perforation and may provide reliable imaging evidence for clinical decision-making.
