Advertisement

Added value of dynamic 3T-MRI to conventional static MRI in evaluation of internal derangement of tempromandibular joint

      Highlights

      • MRI enables well demonstration of complex anatomy of TMJ and its pathological conditions especially internal derangement.
      • Dynamic MRI was a valuable technique for the evaluation of the movement patterns of the condyle & the disc in TMJ internal derangement.
      • Dynamic MRI of the TMJ could assess the biomechanics of the joint and is needed in patients with normal static MRI.

      Abstract

      Purpose

      This prospective study aimed at comparing dynamic T1W fast field echo sequence to the standard static sequences in the evaluation of TMJ disorders using 3T MRI.

      Methods

      8 patients, 14 with bilateral symptomatic internal derangement of TMJ and 4 with unilateral symptoms (32 TMJs) were examined, including 17 females and one male. Static T1W, T2W and PD turbo spin-echo sequences in closed and open mouth positions as well as dynamic T1W-FFE sequence were acquired on 3T MRI unit and images were assessed for the articular disc position, morphological disc changes, condylar morphology and translation. Marginal homogeneity test was used to analyze difference between dynamic and static imaging findings and significant results were considered at p ≤ 0.05.

      Results

      The study shows statistically significant difference between static and dynamic MRI in the evaluation of condylar position (p ≤ 0.005). Out of the examined 32 joints, 28 joints (87.5%) had normal condylar position and 4 joints (12.5%) had a subluxated condyle. Dynamic MRI showed 24 joints (75%) had normal condylar position and 8 joints (25%) had a subluxated condyle. Regarding disc morphology and position, dynamic MRI added no significant superior information compared to standard static images.

      Conclusion

      Static MRI of TMJ provides proper accurate assessment of pathological changes in TMJ disorders and considered the gold standard. Dynamic MRI added superior information regarding joint biomechanics even in normal static MRI cases and valuable findings regarding the movement patterns of the condyle and disc in different types of TMJ internal derangement.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Shaffer S.M.
        • Brismee J.M.
        • Sizer P.S.
        • Courtney C.A.
        Temporomandibular disorders. Part 1: anatomy and examination/diagnosis.
        J Man Manip Ther. 2014; 22: 2-12
        • Krohn S.
        • Joseph A.A.
        • Voit D.
        • Michaelis T.
        • Merboldt K.D.
        • Buergers R.
        • et al.
        Multi-slice real-time MRI of temporomandibular joint dynamics.
        Dentomaxillofac Radiol. 2019 Jan; 4820180162
        • Hasan N.M.
        • Abdelrahman T.E.
        MRI evaluation of TMJ internal derangement: degree of anterior disc displacement correlated with other TMJ soft tissue and osseous abnormalities.
        Egypt JRadiol Nucl Med. 2014 Sep 1; 45: 735-744
        • Petscavage-Thomas J.M.
        • Walker E.A.
        Unlocking the jaw: advanced imaging of the temporomandibular joint.
        Am J Roentgenol. 2014 Nov; 203: 1047-1058
        • Tomas X.
        • Pomes J.
        • Berenguer J.
        • Quinto L.
        • Nicolau C.
        • Mercader J.M.
        • et al.
        MR imaging of temporomandibular joint dysfunction: a pictorial review.
        Radiographics. 2006; 26: 765-781
        • Rudisch A.
        • Innerhofer K.
        • Bertram S.
        • Emshoff R.
        Magnetic resonance imaging findings of internal derangement and effusion in patients with unilateral temporomandibular joint pain.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 566-571
        • Larheim T.A.
        • Westesson P.
        • Sano T.
        Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients.
        Radiology. 2001; 218: 428-432
        • Dalkiz M.
        • Pkdemirli E.
        • Beydemir B.
        Evaluation of temporomandibular joint dysfunction by magnetic reasonance imaging.
        Turk JMed Sci. 2001; 31: 337-343
        • Yen P.
        • Katzberg R.W.
        • Buonocore M.H.
        • Sonico J.
        Dynamic MR imaging of the temporomandibular joint using a balanced steady state free precession sequence at 3T.
        AJNR Am J Neuroradiol. 2013; 34: E24-E26
        • Chen Y.J.
        • Gallo L.M.
        • Meier D.
        • Palla S.
        Dynamic magnetic resonance imaging technique for the study of the temporomandibular joint.
        J Orofac Pain. 2000; 14: 65-73
        • Wang E.Y.
        • Mulholland T.P.
        • Pramanik B.K.
        • Nusbaum A.O.
        • Babb J.
        • Pavone A.G.
        Dynamic sagittal half-fourier acquired single-shot turbo spin-echo MR imaging of the temporomandibular joint: initial experience and comparison with sagittal oblique proton-attenuation images.
        AJNR Am J Neuroradiol. 2007; 28: 1126-1132
        • Cassetta M.
        • Di Carlo S.
        • Pranno N.
        • Stagnitti A.
        • Pompa V.
        • Pompa G.
        The use of high resolution magnetic resonance on 3.0-T system in the diagnosis and surgical planning of intraosseous lesions of the jaws: preliminary results of a retrospective study.
        Eur Rev Med Pharmacol Sci. 2012; 16: 2021-2028
        • Larheim T.A.
        Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint.
        Cells Tissues Organs. 2005; 180: 6-21
        • Takatsuka S.
        • Yoshida K.
        • Ueki K.
        • Maaruwaka K.
        • Nakagawa K.
        • Yamamoto E.
        Disc and condyle translation in patients with temporomandibular disorder.
        Oral Surg Oral Med OralPathol Oral Radiol Endod. 2005; 99: 614-621
        • Kling O.
        • Rödiger M.
        • Zhang S.
        • Frahm J.
        • Gersdorff N.
        Real-time MRI as a new technique for the functional assessment of the temporomandibular joint.
        J Craniomandib Funct. 2013; 5: 9-18
        • Matsubara R.
        • Yanagi Y.
        • Oki K.
        • Hisatomi M.
        • Santos K.C.
        • Bamgbose B.O.
        • et al.
        Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders.
        Dentomaxillofac Radiol. 2018 May; 4720170412
        • Takahara N.
        • Nakagawa S.
        • Sumikura K.
        • Kabasawa Y.
        • Sakamoto I.
        • Harada H.
        Association of temporomandibular joint pain according to magnetic resonance imaging findings in temporomandibular disorder patients.
        J Oral Maxillofac Surg. 2017 Sep 1; 75: 1848-1855
        • Cassetta M.
        • Barchetti F.
        • Pranno N.
        • Marini M.
        Comparing proton density and turbo spin echo T2 weighted static sequences with dynamic half-fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study.
        Dentomaxillofac Radiol. 2014; 4320130387
        • de Bont L.G.
        • van der Kuijl B.
        • Stegenga B.
        • Vencken L.M.
        • Boering G.
        Computed tomography in differential diagnosis of temporomandibular joint disorders.
        Int J Oral Maxillofac Surg. 1993; 22: 200-209
        • Sun Qi
        • Dong Min-Jun
        • Tao Xiao-Feng
        • Qiang Yu.
        • Li Kai-Cheng
        • Yang Chi
        Dynamic MR imaging of temporomandibular joint: an initial assessment with fast imaging employing steady-state acquisition sequence.
        Magn Reson Imaging. 2015; 33: 270-275