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Rofo 2019; 191(10): 924-931
DOI: 10.1055/a-0842-2358
Head/Neck
© Georg Thieme Verlag KG Stuttgart · New York

Welche Rolle spielt die Synovialitis bei der kraniomandibulären Dysfunktion (CMD)? Eine 3T-MRT-Studie

Article in several languages: English | deutsch
Herbert Stimmer
1   Department of Radiology, Klinikum r. d. Isar, Technical University, München, Germany
,
Lucas Ritschl
2   Department of Oral and Maxillofacial Surgery, Klinikum r. d. Isar, Technical University, München, Germany
,
Carolin Goetz
2   Department of Oral and Maxillofacial Surgery, Klinikum r. d. Isar, Technical University, München, Germany
,
Andreas Kolk
2   Department of Oral and Maxillofacial Surgery, Klinikum r. d. Isar, Technical University, München, Germany
,
Benedikt Hofauer
3   ENT-Department, Klinikum r. d. Isar, Technical University, München, Germany
,
Markus Wirth
3   ENT-Department, Klinikum r. d. Isar, Technical University, München, Germany
,
Andreas Knopf
3   ENT-Department, Klinikum r. d. Isar, Technical University, München, Germany
,
Armin Ott
4   Department of Medical Statistics and Epidemiology, Klinikum r. d. Isar, Technical University, München, Germany
,
Klaus-Dietrich Wolff
2   Department of Oral and Maxillofacial Surgery, Klinikum r. d. Isar, Technical University, München, Germany
› Author Affiliations
Further Information

Publication History

20 September 2018

27 December 2018

Publication Date:
12 February 2019 (online)

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Zusammenfassung

Ziel Ziel der vorliegenden Untersuchung war es, das Ausmaß und auch die klinische Bedeutung der Synovialitis beim Syndrom der kraniomandibulären Dysfunktion zu untersuchen.

Material und Methoden Insgesamt 140 Kiefergelenks-MRTs wurden nach Untersuchung mit einem 3T-MR-System ausgewertet. Dabei wurde die synoviale Kontrastmittelaufnahme als entscheidendes Kriterium einer entzündlichen Gelenkbeteiligung quantitativ erfasst und in Relation gesetzt zu Arthrose, Diskusdegeneration, Diskusverlagerung, Gelenkerguss, Knochenmarködem und Einschränkung der Bewegungsexkursion.

Ergebnisse Es zeigte sich ein statistisch hochsignifikanter Zusammenhang zwischen den oben genannten bei CMD häufig vorzufindenden degenerativen Veränderungen einerseits und Zeichen der Synovialitis andererseits.

Schlussfolgerung Die Studie zeigt, dass die typischen MRT-Befunde bei CMD-Patienten häufig münden in bzw. überlagert werden von einer Gelenkentzündung, welche sich manifestiert in Form einer Synovialitis. Es ist davon auszugehen, dass sich diese entzündliche Komponente auswirkt auf das klinische Beschwerdebild und die Prognose. Von Bedeutung ist diese Erkenntnis auch für die Wahl der Therapie.

Kernaussagen: 

  • 3T-MRT mit dedizierter Spule ist die Methode der Wahl zur Abklärung der kraniomandibulären Dysfunktion.

  • Entzündliche Veränderungen der Synovialitis sind MR-tomografisch quantitativ erfassbar und reproduzierbar.

  • Statistisch hochsignifikanter Zusammenhang zwischen degenerativen Veränderungen des Diskus bzw. des Gelenkknorpels und Synovialitis.

  • Ergebnis der Studie relevant für klinisches Verständnis und Therapie der CMD.

Zitierweise

  • Stimmer H, Ritschl L, Goetz C et al. What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A 3T-MRI Study. Fortschr Röntgenstr 2019; 191: 924 – 931

Key words

MR-imaging - temporomandibular joint - arthrosis - intraarticular disc - synovitis
 

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