Analysis with CT and MR images of tendons and aponeurosis in human masseter muscle
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概要
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Trismus is a symptom of muscle malfunction and temporomandibular disorders. All cases of muscle malfunction are accompanied with hyperplasia of the tendon and aponeurosis of the masticatory muscles (HyTAM). We compared images by computed tomography (CT) and magnetic resonance imaging (MRI) to investigate the most suitable image analysis for diagnosis of malfunction of the masseter muscle. Using the best images, we analyzed the distribution of tendon and aponeurosis in the human masseter muscles. Bone, standard and soft kernel CT images were taken with 16 Row multi-detector CT and MR images of various sequences with a 1.5 Tesla MR Scanner (General Electric, Milwaukee, USA) of cow thigh muscles. Based on a previous study, we classified states of the tendon and aponeurosis of human masseter muscles. CT images of HyTAM patients and non-trismus subjects used in this study were compared with each other. The same as with the preceding experimental study, the tendons in 3D MR images were detected at low signal intensity, the same as with the 2D images. Although the 3D structures of the tendons were detected only with the multiplanar reconstruction method, they could not be observed in 3D reconstruction models because there was no signal intensity. In the CT images of the standard and soft kernel, the tendons and aponeurosis were confirmed for CT numbers between 70 and 100. Only in the standard images, could we make out the 3D reconstruction images and observe three-dimensional structures of the tendons. Based on the results of the preceding experimental study, it was determined that in the HyTAM patients, multiple tendons were connected to the mandibular angle from the zygomatic arch. There were few tendons connected to the mandibular angle from the zygomatic arch in the non-trismus subjects. MRI could detect the tendon and aponeurosis, but were not very suitable for observing three-dimensional structures, because the tendon and aponeurosis had no signal intensity. We found that it is possible to observe the conditions of tendon and aponeurosis by utilizing CT images. If hyper-tendon-aponeurosis of the masticatory muscles is the cause of trismus, it will be possible to detect this condition in the tendons of masseter and temporal muscles. By taking advantage of this diagnostic method, we can reduce the number of examinations that have up to now been necessary to diagnose HyTAM.
- 2013-04-00
著者
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Nakajima Masahiro
Second Department Of Oral And Maxillofacial Surgery Osaka Dental University
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Goto Michiko
Graduate School Of Dentistry (second Department Of Oral And Maxillofacial Surgery) Osaka Dental Univ
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Shimizutani Kimishige
Department Of Oral Radiology Osaka Dental University
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Yotsui Yoritaka
Department Of Oral Radiology Osaka Dental University
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Kakudo Kenji
Second Department Of Oral And Maxillofacial Surgery Osak Dental University
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Goto Michiko
Graduate School of Dentistry (Second Department of Oral and Maxillofacial Surgery), Osaka Dental University
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