Diagnostic value of dynamic magnetic resonance imaging of temporomandibular joint dysfunction. (2021)

• Record Type: Journal Article
• Authors: Vogl, Thomas J.; Günther, David; Weigl, Paul; Scholtz, Jan-Erik
• Is Part Of: European journal of radiology open. Volume 8(2021)
• Publication Date: 2021
• Subjects: TMJ Temporomandibular joint -- TMD Temporomandibular joint dysfunction -- ID Internal Derangement -- HASTE Half-Fourier Acquisition Single-shot Turbo spin Echo -- trueFISP true fast imaging with steady state precession -- FLASH Fast Low-Angle Shot -- DDwR disc displacement with reduction -- DDwoR disc displacement without reduction; Temporomandibular joint -- Temporomandibular joint dysfunction -- Static MRI -- Dynamic MRI; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2021.100390
• Languages: English
• ISSNs: 2352-0477

Abstract

Abstract: Background: To estimate the diagnostic value of dynamic magnetic resonance imaging (MRI) for the assessment of the temporomandibular joint (TMJ) compared to standard static MRI sequences in patients with TMJ dysfunction (TMD). Methods and materials: This retrospective study included 71 patients with clinical diagnose of TMD. We acquired 5 static T1- and T2-weighted sequences in parasagittal and paracoronal views and one dynamic sequence (trueFISP) in parasagittal view for each TMJ. Image analysis included evaluation of morphology and function of intra-articular structures and rating of the dynamic images as more, equally, or less informative compared to static MRI sequences. Results: Mean age was 35.0 ± 14.7 years and 50/71 (70.4%) were female. 127/142 (89.4%) TMJs were of diagnostic quality. 42/127 (33.1%) TMJs showed no disc displacement (DD), 56 (44.1%) had DD with disc reduction (DDwR), and 29 (22.8%) had DD without disc reduction (DDwoR). In 38/127 (29.9%) TMJs, dynamic images were rated "more informative", in 84/127 (66.2%) "equally informative", and in 5/127 (3.9%) "less informative" compared to solely static images. Overall, 27/71 (38.0%) patients benefited from additional dynamic sequences compared to solely static images. Dynamic images were "more informative" in TMJs with DDwR (23/56 [41.1%], p < 0.001) and in TMJs with DDwoR (13/29 [44.8%], p = 0.007), while it had no beneficial value for TMJ without DD. For evaluation of joint effusion, static T2-weighted images were rated better in 102/127 (80.3%) TMJs compared to dynamic images (<0.001). Conclusion: Dynamic MRI sequences are beneficial for the evaluation of morphology and function of the TMJ compared to static sequences, especially in patients with temporomandibular disc displacement. Highlights: Dynamic MRI sequences allow direct observation of the joint`s movements. Patients with known or suspected disc displacement benefit the most. Dynamic MRI is a sensible addition to solely static images.