Avaliação da relação entre desarranjos internos de disco das articulações temporomandibulares e variações geométricas do músculo pterigóideo lateral por imagens de ressonância magnética
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Data
2018-11-22
Autores
Silva, Débora Maria da [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A ressonância magnética é o exame de escolha para o estudo das desordens temporomandibulares de disco, considerando-se sua alta definição dos tecidos moles. O objetivo deste estudo foi avaliar a possível relação entre três parâmetros geométricos do músculo pterigóideo lateral (MPL) – o ângulo entre seu longo eixo do e o plano sagital mediano (ANG), seu volume (VOL) e a intensidade do seu sinal (SIN) – e a presença de desarranjos discais (posição e função do disco) em articulações temporomandibulares (ATM) e a presença de dor e ruído articulares, por meio de imagens de ressonância magnética (RM). Foram analisados 39 exames de (RM) (78 ATM) de indivíduos com idades entRe 16 a 71 anos, obtidos em protocolo específico para análise das ATM, pertencentes ao arquivo da disciplina de Radiologia. Foi utilizado o software OnDemand 3D (Cybermed, Seul, Coréia do Sul) para obtenção dos ANG e o software itkSNAP 4.3 (www.itksnap.org) para segmentação do MPL e obtenção de VOL e SIN. A angulação, volume e intensidade do sinal do MPL foram comparados com: posição e função do disco articular, dor articular e presença de ruídos articulares, por meio do teste t de Student, com nível de significância de 5%. Os resultados indicaram que foram encontradas diferenças significativas apenas entre a presença de dor no MPL e sua angulação (p<0,0001), para ambos os lados, não sendo encontradas diferenças significantes para todas as demais variáveis estudadas (p>0,05). Concluiu-se que, na amostra estudada, um valor maior do ângulo sagital do MPL relacionava-se com a presença de dor neste grupo muscular.
Magnetic resonance imaging is the examination of choice for the study of temporomandibular disc disorders, considering its high definition of soft tissues. The objective of this study was to evaluate the possible relationship between three geometric parameters of the lateral pterygoid muscle (LPM) - angle between its long axis and median sagittal plane (ANG), its volume (VOL) and its signal intensity (SIN) – and disc derangements (disc position and disc function) of the temporomandibular joint (TMJ), joint pain. A total of 39 magnetic resonance (MRI) exams (78 TMJ) were analyzed from individuals aged 16 to 71 years, obtained in a specific protocol for the analysis of TMJ, belonging to the archive of the discipline of Radiology. OnDemand 3D software (Cybermed, Seoul, South Korea) was used to obtain ANG and itkSNAP 4.3 software (www.itksnap.org) for LPM segmentation and obtaining VOL and SIN. The LPM angle, volume and signal intensity were compared to: position and function of the articular disc, articular pain and presence of articular noise, using Student's t test, with a level of significance of 5%. The results indicated that significant differences were found only between the presence of LPM pain and its angle (p <0.0001) for both sides, and no significant differences were found for all other variables studied (p> 0.05). It was concluded that, in this sample, a greater value of the sagittal angle of LPM was related to the presence of pain in this muscle group
Magnetic resonance imaging is the examination of choice for the study of temporomandibular disc disorders, considering its high definition of soft tissues. The objective of this study was to evaluate the possible relationship between three geometric parameters of the lateral pterygoid muscle (LPM) - angle between its long axis and median sagittal plane (ANG), its volume (VOL) and its signal intensity (SIN) – and disc derangements (disc position and disc function) of the temporomandibular joint (TMJ), joint pain. A total of 39 magnetic resonance (MRI) exams (78 TMJ) were analyzed from individuals aged 16 to 71 years, obtained in a specific protocol for the analysis of TMJ, belonging to the archive of the discipline of Radiology. OnDemand 3D software (Cybermed, Seoul, South Korea) was used to obtain ANG and itkSNAP 4.3 software (www.itksnap.org) for LPM segmentation and obtaining VOL and SIN. The LPM angle, volume and signal intensity were compared to: position and function of the articular disc, articular pain and presence of articular noise, using Student's t test, with a level of significance of 5%. The results indicated that significant differences were found only between the presence of LPM pain and its angle (p <0.0001) for both sides, and no significant differences were found for all other variables studied (p> 0.05). It was concluded that, in this sample, a greater value of the sagittal angle of LPM was related to the presence of pain in this muscle group
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Palavras-chave
Transtornos da articulação temporomandibular, Disco da articulação temporomandibular, Imagem por ressonância magnética, Temporomandibular joint disorders, Temporomandibular joint disc, Magnetic resonance imaging