턱관절 부위의 골관절염 상태 진단에 대한 bone SPECT/CT fused image의 효용성

Abstract

Purpose : The objective of this study was to evaluate the effectiveness of bone SPECT/CT fused image for the diagnosis of temporomandibular joint (TMJ) arthritis.

Patients and Methods : From January 2011 to July 2012, 17 patients (3 males and 14 females) who visited Department of Oral & Maxillofacial Surgery, Hanyang University Hospital, Republic of Korea, were diagnosed primarily with condyle resorption and bony change by plain radiography (panorama and transcranial view). And these patients were taken by bone SPECT and facial 3D CT. Through the CT image and clinical examination, Thirty four TMJs of these patients were distributed by 4 groups : normal, internal derangement, osteoarthritis, osteoarthrosis groups. These 34 TMJ’s radiotracer uptake ratios were measured.

Results : Significant results were obtained when comparing uptake ratios between diagnostic groups each other. And between osteoarthritis group and non osteoarthritis group also showed the significant difference when the uptake ratio were compared. But there was no significant correlation about the uptake ratio according to bony change itself on condyle.

Conclusion : It was concluded from this study that bone SPECT/CT fused image may help to evaluate the state and degree of temporomandibular joint in terms of osteoarthritis. |목적 : 이번 연구의 목적은 턱관절 부위 골흡수의 진행성 여부 혹은 하악과두 골변화의 급,만성 상태에 대한 평가에 있어서 bone SPECT/CT 합성 영상의 활용과 그 효용성에 대해 알아보는 것이다. . 연구 대상 및 방법 : 임상검사와 표준 방사선 검사를 통해 1차적으로 하악과두 골흡수 내지는 골변화 양상으로 의심되는 17명의 환자의 CT영상과 bone SPECT 영상을 얻었다. CT와 bone SPECT의 합성 영상을 통해 CT상의 골결손 부위를 파악하여 SPECT상에서 추적성분의 비정상 섭취 비율을 측정하였다. 임상검사와 CT 영상을 기준으로 분류된 4개 군간 추적성분 섭취 비율과 골 변화양상 여부 관련성을 조사하여 하악과두의 골흡수의 상태 진단 및 치료에 있어서 bone SPECT/CT 합성 영상의 효용성을 평가한다. . 결과 : 임상검사와 CT 영상을 기준으로 분류된 4개의 1차 진단 군 간에서 유의성 있는 추적성분 섭취 비율 차이를 보여주었으며 또한 임상검사와 CT 영상을 통해 연구진단 기준으로 분류한 관절염 군과 비 관절염 군 간에서도 유의성 있는 추적성분 섭취 비율 차이를 보여주었다. 반면 CT 상에서 보여지는 골성 변화 여부 자체는 추적성분 섭취 비율과 통계적으로 유의할만한 차이를 보여주지 않았다.

결론 : bone SPECT/CT 합성 영상을 통하여 현재 하악과두의 형태학적 이상뿐만 아니라 진행성 여부 또한 판단하여 턱관절 부위에서의 골관절염의 진단과 치료에 있어서 정확성을 도모할 수 있을 것이다.; Purpose : The objective of this study was to evaluate the effectiveness of bone SPECT/CT fused image for the diagnosis of temporomandibular joint (TMJ) arthritis.

Patients and Methods : From January 2011 to July 2012, 17 patients (3 males and 14 females) who visited Department of Oral & Maxillofacial Surgery, Hanyang University Hospital, Republic of Korea, were diagnosed primarily with condyle resorption and bony change by plain radiography (panorama and transcranial view). And these patients were taken by bone SPECT and facial 3D CT. Through the CT image and clinical examination, Thirty four TMJs of these patients were distributed by 4 groups : normal, internal derangement, osteoarthritis, osteoarthrosis groups. These 34 TMJ’s radiotracer uptake ratios were measured.

Results : Significant results were obtained when comparing uptake ratios between diagnostic groups each other. And between osteoarthritis group and non osteoarthritis group also showed the significant difference when the uptake ratio were compared. But there was no significant correlation about the uptake ratio according to bony change itself on condyle.

Conclusion : It was concluded from this study that bone SPECT/CT fused image may help to evaluate the state and degree of temporomandibular joint in terms of osteoarthritis.