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Maracci LM, Savegnago GDO, Antoniazzi RP, Marquezan M, Silva TB, Liedke GS. Influence of examiner calibration on clinical and MRI diagnosis of temporomandibular joint disc displacement: a systematic review and meta-analysis. Dentomaxillofac Radiol 2024; 53:341-353. [PMID: 38970385 PMCID: PMC11358637 DOI: 10.1093/dmfr/twae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 05/17/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVES This study aimed to verify the accuracy of clinical protocols for the diagnosis of disc displacement (DD) compared with MRI, considering examiners' calibration. METHODS PubMed, Cochrane (Central), Scopus, Web of Science, LILACS, Embase, Science Direct, Google Scholar, and DANS EASY Archive databases were searched. Two reviewers independently screened and selected the studies. A meta-analysis was conducted using the R Statistical software. Results are shown using sensitivity and specificity, and 95% confidence intervals. RESULTS Of the 20 studies included in the systematic review, only three were classified as low risk of bias. Seventeen studies were included in the meta-analysis. Compared to MRI, clinical protocols showed overall sensitivity and specificity of 0.75 (0.63-0.83) and 0.73 (0.59-0.84) for DD diagnosis, respectively. For DD with reduction, sensitivity was 0.64 (0.48-0.77) and specificity was 0.72 (0.48-0.87). For DD without reduction, sensitivity was 0.58 (0.39-0.74) and specificity 0.93 (0.83-0.97). Only 8 studies reported examiner calibration when performing clinical and/or MRI evaluation; nevertheless, calibration showed a tendency to improve the diagnosis of DD. CONCLUSION The sensitivity and specificity of clinical protocols in the diagnosis of DD are slightly below the recommended values, as well as the studies lack calibration of clinical and MRI examiners. Examiner calibration seems to improve the diagnosis of DD.
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Affiliation(s)
- Lucas Machado Maracci
- Dental Sciences Post-Graduation Program, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | | | - Raquel Pippi Antoniazzi
- Dental Sciences Post-Graduation Program, Department of Stomatology, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | - Mariana Marquezan
- Dental Sciences Post-Graduation Program, Department of Stomatology, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | - Tatiana Bernardon Silva
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | - Gabriela Salatino Liedke
- Dental Sciences Post-Graduation Program, Department of Stomatology, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
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Radin E, Marcuzzo AV, de Groodt J, Degrassi F, Calderan L, Ramella V, Tirelli G, Ukmar M, Cova MA. MRI-based assessment of the mylohyoid muscle in oral squamous cell carcinoma, a 7-point scoring method. Eur Radiol 2024:10.1007/s00330-024-11016-8. [PMID: 39210160 DOI: 10.1007/s00330-024-11016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 07/04/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM). MATERIALS AND METHODS We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman's rank coefficient. Receiver operating characteristic curves were employed to assess the score's ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann-Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen's K statistical coefficient was used to evaluate the interobserver agreement. RESULTS Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57-0.99), specificity 61% (CI: 0.45-0.76), PPV 38% (CI: 0.21-0.59), and NPV 96% (CI: 0.78-0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57-0.99), specificity 70% (CI: 0.53-0.82), PPV 45% (CI: 0.25-0.67), and NPV 96% (CI: 0.80-0.99). CONCLUSION The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences. CLINICAL RELEVANCE STATEMENT Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon. KEY POINTS The relationship of the MM to an oral lesion may impact surgical planning. As the score increases, there is a greater incidence of infiltration in the MM. Our score system improves radiologists' reporting for MM involvement by tumor.
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Affiliation(s)
- E Radin
- Department of Radiology, University of Trieste, Trieste, Italy.
| | - A V Marcuzzo
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Trieste, Italy
| | - J de Groodt
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Trieste, Italy
| | - F Degrassi
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Trieste, Italy
| | - L Calderan
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Trieste, Italy
| | - V Ramella
- Department of Plastic, Reconstructive and Aesthetic Surgery, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, University of Trieste, Trieste, Italy
| | - G Tirelli
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, University of Trieste, Trieste, Italy
| | - M Ukmar
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, University of Trieste, Trieste, Italy
| | - M A Cova
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, University of Trieste, Trieste, Italy
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Kakimoto N, Wongratwanich P, Shimamoto H, Kitisubkanchana J, Tsujimoto T, Shimabukuro K, Verdonschot RG, Hasegawa Y, Murakami S. Comparison of T2 values of the displaced unilateral disc and retrodiscal tissue of temporomandibular joints and their implications. Sci Rep 2024; 14:1705. [PMID: 38242921 PMCID: PMC10798969 DOI: 10.1038/s41598-024-52092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/13/2024] [Indexed: 01/21/2024] Open
Abstract
Unilateral anterior disc displacement (uADD) has been shown to affect the contralateral joints qualitatively. This study aims to assess the quantitative T2 values of the articular disc and retrodiscal tissue of patients with uADD at 1.5 Tesla (T). The study included 65 uADD patients and 17 volunteers. The regions of interest on T2 maps were evaluated. The affected joints demonstrated significantly higher articular disc T2 values (31.5 ± 3.8 ms) than those of the unaffected joints (28.9 ± 4.5 ms) (P < 0.001). For retrodiscal tissue, T2 values of the unaffected (37.8 ± 5.8 ms) and affected joints (41.6 ± 7.1 ms) were significantly longer than those of normal volunteers (34.4 ± 3.2 ms) (P < 0.001). Furthermore, uADD without reduction (WOR) joints (43.3 ± 6.8 ms) showed statistically higher T2 values than the unaffected joints of both uADD with reduction (WR) (33.9 ± 3.8 ms) and uADDWOR (38.9 ± 5.8 ms), and the affected joints of uADDWR (35.8 ± 4.4 ms). The mean T2 value of the unaffected joints of uADDWOR was significantly longer than that of healthy volunteers (P < 0.001). These results provided quantitative evidence for the influence of the affected joints on the contralateral joints.
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Affiliation(s)
- Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Pongsapak Wongratwanich
- Division of Oral Diagnosis, Department of Oral Biomedical Sciences, Khon Kaen University, Khon Kaen, Thailand.
| | - Hiroaki Shimamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Jira Kitisubkanchana
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Tomomi Tsujimoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kiichi Shimabukuro
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Isaieva K, Leclère J, Felblinger J, Gillet R, Dubernard X, Vuissoz PA. Methodology for quantitative evaluation of mandibular condyles motion symmetricity from real-time MRI in the axial plane. Magn Reson Imaging 2023; 102:115-125. [PMID: 37187265 DOI: 10.1016/j.mri.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
Diagnosis of temporomandibular disorders is currently based on clinical examination and static MRI. Real-time MRI enables tracking of condylar motion and, thus, evaluation of their motion symmetricity (which could be associated with temporomandibular joint disorders). The purpose of this work is to propose an acquisition protocol, an image processing approach, and a set of parameters enabling objective assessment of motion asymmetry; to check the reliability and find the limitations of the approach, and to verify if the automatically calculated parameters are associated with the motion symmetricity. A rapid radial FLASH sequence was used to acquire a dynamic set of axial images for 10 subjects. One more subject was involved to estimate the dependence of the motion parameters on the slice placement. The images were segmented with a semi-automatic approach based on U-Net convolutional neural network, and the condyles' mass centers were projected on the mid-sagittal axis. Resulting projection curves were used for the extraction of various motion parameters including latency, velocity peak delay, and maximal displacement between the right and the left condyle. These automatically calculated parameters were compared with the physicians' scores. The proposed segmentation approach allowed a reliable center of mass tracking. Latency and velocity peak delay were found to be invariant to the slice position, and maximal displacement difference considerably varied. The automatically calculated parameters demonstrated a significant correlation with the experts' scores. The proposed acquisition and data processing protocol enables the automatizable extraction of quantitative parameters that characterize the symmetricity of condylar motion.
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Affiliation(s)
- Karyna Isaieva
- IADI, University of Lorraine, INSERM U1254, Nancy, France.
| | - Justine Leclère
- IADI, University of Lorraine, INSERM U1254, Nancy, France; Oral Medicine Department, University Hospital of Reims, Reims, France
| | - Jacques Felblinger
- IADI, University of Lorraine, INSERM U1254, Nancy, France; CIC-IT 1433, INSERM, CHRU de Nancy, Nancy, France
| | - Romain Gillet
- IADI, University of Lorraine, INSERM U1254, Nancy, France; Guilloz Imaging Department, CHRU of Nancy, Nancy, France
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Intra- and inter-examination reproducibility of T2 mapping for temporomandibular joint assessment at 3.0 T. Sci Rep 2022; 12:10993. [PMID: 35768628 PMCID: PMC9243045 DOI: 10.1038/s41598-022-15184-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
T2 mapping allows quantification of the temporomandibular joint (TMJ) ultrastructural degeneration. The study aimed to assess intra- and inter-examination reproducibility of T2 mapping for TMJ evaluation at 3.0 Tesla (T). Seventeen volunteers, regardless of temporomandibular disorder (TMD) diagnosis, received magnetic resonance (MR) examination at 3.0 T. T2 mapping was performed twice (> 5 min between sessions without repositioning) on 12 volunteers to ensure intra-examination reproducibility. Nine volunteers underwent two examinations (> 6 months) to ensure inter-examination reproducibility. The regions of interest (ROIs) of the articular disc and retrodiscal tissue were manually selected and calculated. The mean T2 values of the articular disc and retrodiscal tissue were 25.3 ± 3.0 and 30.0 ± 4.1 ms, respectively. T2 mapping showed excellent intra-examination intraclass correlation coefficients (ICCs) for both articular disc (0.923) and retrodiscal tissue (0.951). Very strong correlations (r) were observed in both articular disc (0.928) and retrodiscal tissue (0.953) (P < .001). Inter-examination reproducibility also demonstrated that the ICCs were excellent (0.918, 0.935) on both ROIs. T2 values between first and second examinations were strongly correlated (r = 0.921, 0.939) (P < .001). In conclusion, T2 mapping seems to be a promising tool for TMJ assessment, regardless of the TMJ condition.
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Uchiyama Y, Sasai T, Murakami S. Multiple-echo recombined gradient echo MR imaging of the temporomandibular joint. Oral Radiol 2022; 38:490-496. [PMID: 35022930 DOI: 10.1007/s11282-021-00579-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/19/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to compare images generated by a multiple-echo recombined gradient echo (MERGE) with the proton density-weighted fast spin-echo (PD-weighted FSE) sequence, T1-weighted fast spin-echo sequence (T1-weighted FSE), and T2-weighted fast spin-echo sequence (T2-weighted FSE) for the diagnostic imaging of the temporomandibular joint (TMJ). MATERIALS AND METHODS Twenty-three patients with signs and symptoms of TMJ dysfunction were enrolled in this study. The four imaging modalities were used to examine the TMJ. Three images (lateral, middle, and medial parts of the condylar head) were reviewed by two radiologists, who rated the visibility of the disk and cortex of the condylar head. RESULTS For the medial part of the TMJ, in cases with a normally positioned disk, the results of the MERGE and PD-weighted FSE techniques were significantly better than those of the T1-weighted FSE and T2-weighted FSE. For visibility of the cortex in the normally positioned disk, MERGE was significantly better than PD-weighted FSE [P < 0.0125 (0.05/4)] at the middle and medial parts of the TMJ. MERGE was also significantly better than T1-weighted FSE [P < 0.0125 (0.05/4)] and T2-weighted FSE [P < 0.0125 (0.05/4)]. CONCLUSION MERGE is better for visualizing the condylar only at the middle and the medial aspects of the TMJ in a normally positioned disk.
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Affiliation(s)
- Yuka Uchiyama
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tadashi Sasai
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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7
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Willenbrock D, Lutz R, Wuest W, Heiss R, Uder M, Behrends T, Wurm M, Kesting M, Wiesmueller M. Imaging temporomandibular disorders: Reliability of a novel MRI-based scoring system. J Craniomaxillofac Surg 2021; 50:230-236. [PMID: 34893389 DOI: 10.1016/j.jcms.2021.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 10/05/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022] Open
Abstract
The aim of this study was to assess the inter- and intrarater reliability of a recently proposed scoring system for temporomandibular disorders (TMD), based upon radiological findings from magnetic resonance imaging (MRI). Patients with clinically suspected uni- or bilateral TMD, and subsequently conducted MRI examination of both temporomandibular joints, were included in this study. MRI data were independently evaluated by two experienced radiologists according to the DLJ scoring system proposed by Wurm et al., which includes assessment of the following categories: articular disk (prefix 'D'), direction of disk luxation (prefix 'L'), and osseous joint alterations (prefix 'J'). 60 patients (49 female and 11 male) were eligible for analysis. No significant differences were found between both observers regarding 'D' and 'L' scores (p = 0.13 and p = 0.59, respectively). Significant differences were found for the assessment of subtle osseous changes ('J0' category: p = 0.041; 'J1' category: p = 0.018). Almost perfect intra- and interrater agreements were found for 'D' and 'L' categories (intrarater and interrater agreements for 'D': κ = 0.92 and κ = 0.84, respectively; intrarater and interrater agreements for 'L': κ = 0.93 and κ = 0.89, respectively). However, the assessment of 'J' categories revealed only moderate interrater agreement (κ = 0.49). The DLJ scoring system based upon MRI findings is feasible for routine clinical TMD assessment, and may help to simplify interdisciplinary communication between radiologists and clinicians.
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Affiliation(s)
- Dorina Willenbrock
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Wolfgang Wuest
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Rafael Heiss
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Tessa Behrends
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Matthias Wurm
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Marco Wiesmueller
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Maximiliansplatz 3, 91054, Erlangen, Germany.
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Relationship between Clinical Symptoms and Magnetic Resonance Imaging in Temporomandibular Disorder (TMD) Patients Utilizing the Piper MRI Diagnostic System. J Clin Med 2021; 10:jcm10204698. [PMID: 34682820 PMCID: PMC8539230 DOI: 10.3390/jcm10204698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 02/02/2023] Open
Abstract
Clinical problems of the temporomandibular joint (TMJ) and the masticatory musculature are both included in the term temporomandibular disorder (TMD). The purpose of the present study was to examine the pathology of the joints of patients diagnosed with TMD utilizing the dedicated Piper MRI-based classification, and to link these pathologies with various symptoms while considering their severity. In total, 64 patients with clinical TMD were examined. Symptoms were recorded using a questionnaire. The clinical examination included diagnosing the occlusion in centric relation, which was followed by a standardized MRI. It was confirmed that, although they occurred in a high percentage in all classes, muscle pain and occlusal interference are not indicators of TMJ damage. The results indicate that the progressive degradation of the TMJ, represented by qualification to the higher Piper classes, is associated with an increase in TMJ pain only up to a certain stage. For the highest Piper classes, the joint pain occurs in a smaller percentage of patients, but sounds are more frequent.
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Satoh K, Satoh K, Imaizumi-Ohashi Y, Yokoi-Hayakawa M, Fukada T, Seo Y. Rat mandibular condyle and fossa grew separately then unified as a single joint at 20 days old, which was the weaning age. J Oral Sci 2020; 62:197-201. [PMID: 32224572 DOI: 10.2334/josnusd.19-0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Magnetic resonance imaging (MRI) was used to observe growth of the mandibular condyle, mandibular fossa, and articular disc as a single unit. Changes in each component's relative position and size were observed using 7-tesla MRI. Mandibular condyle chondrocytes' growth was evaluated with immunohistochemistry, using the expression of zinc transporter ZIP13. Three-dimensional T1-weighted (T1w) MRI was used to obtain images of the TMJ of Sprague Dawley rats at 4-78 days old (P4-78) with a voxel resolution of 65 μm. Two-dimensional T1w MR images were acquired after a subcutaneous injection of the contrast reagent gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). The T1w MR images showed that the mandibular condyle was located posterior to the mandibular fossa until P20; however, it then moved to a location underneath the mandibular fossa. In the Gd-DTPA enhanced images, the articular disc was identified as a region with lower signal intensity from P20. The number of ZIP13-positive chondrocytes at P6 was larger than the number at P24. In conclusion, the mandibular condyle with cartilage and disc grows on the posterior side of the mandibular fossa until P20, which was the weaning age. Then, the condyle fit into the mandibular fossa and completed the functional unit.
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Affiliation(s)
- Keitaro Satoh
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine.,Department of Pharmacology, Asahi University School of Dentistry
| | - Kaori Satoh
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine
| | | | - Mika Yokoi-Hayakawa
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine
| | - Toshiyuki Fukada
- Faculty of Pharmaceutical Sciences, Tokushima Bunri University.,Division of Pathology, Department of Oral Diagnostic Sciences, School of Dentistry, Showa University.,Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences
| | - Yoshiteru Seo
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine
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Sun Q, Dong MJ, Tao XF, Jiang MD, Yang C. Selection and application of coils in temporomandibular joint MRI. Dentomaxillofac Radiol 2019; 49:20190002. [PMID: 31559845 PMCID: PMC7068082 DOI: 10.1259/dmfr.20190002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: To compare and evaluate the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) values between a 15-channel phased array head coil and 6-channel dS Flex M surface coil in the MRI of temporomandibular joint. Methods: 300 patients were randomly assigned to two groups: 150 patients were examined by using a 15-channel phased array head coil and the other 150 patients were scanned by using a 6-channel dS Flex M surface coil. All of the data were set in the same 6 regions of interest including the temporal lobe, condyle neck, lateral pterygoid muscle, parotid gland, the adipose area and an area of the background noise). SNR and CNR values were measured respectively. Results: The numerical variation law of SNR and CNR values measured in regionsof interest of each group was similar, although different coils were used. There were statistically significant differences of SNR values in all of the oblique sagittal (OSag) proton density-weighted imaging, the part of OSag T2 weighted image (T2WI) except for SNR4 and SNR5. and oblique coronal (OCor) T2WI sequence except for SNR2. On the contrary, SNR4 and SNR5 values in the OCor T2WI and SNR5 values in OSag T2WI sequences by using the surface coil were higher than those by using the head coil. There were no statistically significant intergroup differences of CNR values in OSag proton density-weighted imaging sequence except CNR1 and in OSag T2WI sequence except CNR5. But, statistically significant differences of all the values in the OCor T2WI sequence except for CNR1 were observed. Conclusion: Both the phased array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI.
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Affiliation(s)
- Qi Sun
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min-Jun Dong
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Feng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Meng-da Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Key Lab of Stomatology, Shanghai, China
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Bristela M, Skolka A, Eder J, Szomolanyi P, Weber M, Piehslinger E, Schmid-Schwap M, Trattnig S. T2 mapping with 3.0 T MRI of the temporomandibular joint disc of patients with disc dislocation. Magn Reson Imaging 2019; 58:125-134. [DOI: 10.1016/j.mri.2019.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/11/2018] [Accepted: 02/05/2019] [Indexed: 11/28/2022]
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12
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Sagl B, Schmid-Schwap M, Piehslinger E, Kronnerwetter C, Kundi M, Trattnig S, Stavness I. In vivo prediction of temporomandibular joint disc thickness and position changes for different jaw positions. J Anat 2019; 234:718-727. [PMID: 30786005 DOI: 10.1111/joa.12951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2019] [Indexed: 12/31/2022] Open
Abstract
Temporomandibular joint disorders (TMD) are common dysfunctions of the masticatory region and are often linked to dislocation or changes of the temporomandibular joint (TMJ) disc. Magnetic resonance imaging (MRI) is the gold standard for TMJ imaging but standard clinical sequences do not deliver a sufficient resolution and contrast for the creation of detailed meshes of the TMJ disc. Additionally, bony structures cannot be captured appropriately using standard MRI sequences due to their low signal intensity. The objective of this study was to enable researchers to create high resolution representations of all structures of the TMJ and consequently investigate morphological as well as positional changes of the masticatory system. To create meshes of the bony structures, a single computed tomography (CT) scan was acquired. In addition, a high-resolution MRI sequence was produced, which is used to collect the thickness and position change of the disc for various static postures using bite blocks. Changes in thickness of the TMJ disc as well as disc translation were measured. The newly developed workflow successfully allows researchers to create high resolution models of all structures of the TMJ for various static positions, enabling the investigation of TMJ disc translation and deformation. Discs were thinnest in the lateral part and moved mainly anteriorly and slightly medially. The procedure offers the most comprehensive picture of disc positioning and thickness changes reported to date. The presented data can be used for the development of a biomechanical computer model of TMJ anatomy and to investigate dynamic and static loads on the components of the system, which could be useful for the prediction of TMD onset.
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Affiliation(s)
- Benedikt Sagl
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Martina Schmid-Schwap
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Eva Piehslinger
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Claudia Kronnerwetter
- Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria
| | - Michael Kundi
- Institute of Environmental Health, Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria.,CD Laboratory for Clinical Molecular MR Imaging, Medical University of Vienna, Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
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Chen X, Qian T, Kober T, Zhang G, Ren Z, Yu T, Piao Y, Chen N, Li K. Gray-matter-specific MR imaging improves the detection of epileptogenic zones in focal cortical dysplasia: A new sequence called fluid and white matter suppression (FLAWS). NEUROIMAGE-CLINICAL 2018; 20:388-397. [PMID: 30128277 PMCID: PMC6095948 DOI: 10.1016/j.nicl.2018.08.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/09/2018] [Accepted: 08/07/2018] [Indexed: 11/25/2022]
Abstract
Objectives To evaluate the diagnostic value and characteristic features of FCD epileptogenic zones using a novel sequence called fluid and white matter suppression (FLAWS). Materials and methods Thirty-nine patients with pathologically confirmed FCD and good surgery outcomes (class I or II, according to the Engel Epilepsy Surgery Outcome Scale) were retrospectively included in the study. All the patients underwent a preoperative whole-brain MRI examination that included conventional sequences (T2WI, T1WI, two-dimensional (2D) axial, coronal fluid-attenuated inversion recovery [FLAIR]) and FLAWS. An additional 3D-FLAIR MRI sequence was performed in 17 patients. To evaluate the sensitivity and specificity of FLAWS and investigate the cause of false-positives, 36 healthy volunteers were recruited as normal controls. Two radiologists evaluated all the image data. The detection rates of the FCD epileptogenic zone on different sequences were compared based on five criteria: abnormal cortical morphology (thickening, thinning, or abnormally deep sulcus); abnormal cortical signal intensity; blurred gray-white matter junction; abnormal signal intensity of the subcortical white matter, and the transmantle sign. The sensitivity and specificity of FLAWS for detecting the FCD lesions were calculated with the reviewers blinded to all the clinical information, i.e. to the patient identity and the location of the resected regions. To explore how many features were sufficient for the diagnosis of the epileptogenic zones, the frequency of each criterion in the resected regions and their combinations were assessed on FLAWS, according to the results of the assessment when the reviewers were aware of the location of the resected regions. Based on the findings of the 17 patients with an additional 3D-FLAIR scan when the reviewers were aware of the location of the resected regions, quantitative analysis of the regions of interest was used to compare the tissue contrast among 2D-axial FLAIR, 3D-FLAIR, and the FLAWS sequence. Visualization score analysis was used to evaluate the visualization of the five features on conventional, 3D-FLAIR, and FLAWS images. Finally, to explore the reason for false-positive results, a further evaluation of the whole brain FLAWS images was conducted for all the subjects. Results The sensitivity and specificity for detecting the FCD lesions on the FLAWS sequence were 71.9% and 71.1%, respectively. When the reviewers were blinded to the location of the resected regions, the detection rate of the FLAWS sequence was significantly higher than that of the conventional sequences (P = 0.00). In the 17 patients who underwent an additional 3D FLAIR scan, no statistically significant difference was found between the FLAWS and the 3D-FLAIR (P = 0.25). All the patients had at least two imaging features, one of which was “the blurred junction of the gray-white matter.” The transmantle sign, which is widely believed to be a specific feature of FCD type II, could also be observed in type I on the FLAWS sequence. The relative tissue contrast of FLAWS was higher than that of the 2D-FLAIR with respect to lesion/white matter (WM), deep gray matter (GM)/WM, and cortex/WM (P = 0.00 for all three measures) and higher than that of the 3D-FLAIR with respect to the lesion/WM (P = 0.01). The visualization score analysis showed that the visualization of FLAWS was more enhanced than that of the conventional and 3D-FLAIR images with respect to the blurred junction (P = 0.00 for both comparisons) and the abnormal signal intensity of the subcortical white matter (P = 0.01 for both comparisons). The thin-threadlike signal and individual FCD features outside the epileptogenic regions were considered the primary cause of the false-positive results of FLAWS. Conclusions FLAWS can help in the detection of FCD epileptogenic zones. It is recommended that epileptogenic zone on FLAWS be diagnosed based on a combination of two features, one of which should be the “blurred junction of the gray-white matter” in types I and II. In type III, the combination of “the blurred junction of the gray-white matter” with “abnormal signal intensity of subcortical white matter” is recommended. FLAWS can help in the detection of FCD epileptogenic zones. Diagnosis of FCD lesions should be based on a combination of two features. The transmantle sign is not specific for FCD type II on FLAWS.
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Affiliation(s)
- Xin Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China
| | - Tianyi Qian
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China; MR Collaborations NE Asia, Siemens Healthcare, Beijing, PR China
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare HC CEMEA SUI DI PI, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Guojun Zhang
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, PR China
| | - Zhiwei Ren
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, PR China
| | - Tao Yu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, PR China
| | - Yueshan Piao
- Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, PR China
| | - Nan Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China.
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China
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14
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Qualitative and semi-quantitative assessment of temporomandibular joint MRI protocols for juvenile idiopathic arthritis at 1.5 and 3.0T. Eur J Radiol 2017; 98:90-99. [PMID: 29279176 DOI: 10.1016/j.ejrad.2017.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/20/2017] [Accepted: 10/25/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Temporomandibular joints (TMJs) frequently develop silent inflammatory and osteochondral changes in children with juvenile idiopathic arthritis. Data-driven recommendations for TMJ imaging protocol are needed to reduce measurement error and scanning time. This study compares the impact of different protocols, imaging coils, and magnet strength on the reliability of image assessment and the subjective quality of images. MATERIALS AND METHODS Three groups of bilateral TMJ MR studies were retrospectively collected from two institutions, including 24 1.5T and 19 3.0T studies using dedicated TMJ surface coils, and 23 1.5T studies with head coil. Post-contrast sequences were re-compiled from the full protocol to create minimum protocol studies for the three groups. Two radiologists and two non-radiologists first scored the three minimum protocol images according to pre-specified definitions, then scored the full protocol images. Minimum-to-full protocol agreement, inter-reader agreement, and subjective item visibility scores were assessed. RESULTS With dedicated TMJ dual surface coils, minimum-vs-full protocol agreement was moderate to good (0.5-0.8 intraclass correlation coefficients or kappa) for most items, and was not influenced by the magnet strength. Inter-reader reliability was more significantly influenced by the imaging coil and reader's training background than by protocol length or magnet strength differences. Sagittal and coronal planes weighted on PD, T2 Fat Suppressed and T1 Fat Suppressed -postcontrast adequately visualized all the different features, whereas the axial plane was more limited to visualizing synovium. CONCLUSION Inter-reader reliability and qualitative measure of image quality improved more consistently with the coil offering the higher resolution, rather than increased magnet strength.
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15
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Using 3 Tesla magnetic resonance imaging in the pre-operative evaluation of tongue carcinoma. J Laryngol Otol 2017; 131:793-800. [PMID: 28683842 DOI: 10.1017/s0022215117001360] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to evaluate the role of 3 Tesla magnetic resonance imaging in predicting tongue tumour thickness via direct and reconstructed measures, and their correlations with corresponding histological measures, nodal metastasis and extracapsular spread. METHODS A prospective study was conducted of 25 patients with histologically proven squamous cell carcinoma of the tongue and pre-operative 3 Tesla magnetic resonance imaging from 2009 to 2012. RESULTS Correlations between 3 Tesla magnetic resonance imaging and histological measures of tongue tumour thickness were assessed using the Pearson correlation coefficient: r values were 0.84 (p < 0.0001) and 0.81 (p < 0.0001) for direct and reconstructed measurements, respectively. For magnetic resonance imaging, direct measures of tumour thickness (mean ± standard deviation, 18.2 ± 7.3 mm) did not significantly differ from the reconstructed measures (mean ± standard deviation, 17.9 ± 7.2 mm; r = 0.879). Moreover, 3 Tesla magnetic resonance imaging had 83 per cent sensitivity, 82 per cent specificity, 82 per cent accuracy and a 90 per cent negative predictive value for detecting cervical lymph node metastasis. CONCLUSION In this cohort, 3 Tesla magnetic resonance imaging measures of tumour thickness correlated highly with the corresponding histological measures. Further, 3 Tesla magnetic resonance imaging was an effective method of detecting malignant adenopathy with extracapsular spread.
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16
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Kohinata K, Matsumoto K, Suzuki T, Tsunoda M, Hayashi Y, Araki M, Hashimoto K, Honda K. Retrospective magnetic resonance imaging study of risk factors associated with sideways disk displacement of the temporomandibular joint. J Oral Sci 2017; 58:29-34. [PMID: 27021537 DOI: 10.2334/josnusd.58.29] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
As part of our ongoing investigation of risk and predictive factors associated with temporomandibular disorders, we used magnetic resonance imaging (MRI) to identify risk factors for sideways disk displacement of the temporomandibular joint in 26 patients with MRI-confirmed unilateral pure sideways disk displacement (medial or lateral disk displacement) and normal positioning of the contralateral temporomandibular joint. Coronal morphologic harmonization between the condyle and fossa, angle between the axis of the ramus and condyle, and angle between the lateral pterygoid muscle (LPM) and condyle were evaluated. Only angle of the LPM related to the condyle was significantly correlated with mediolateral disk position; the angles of joints with medial, normal, and lateral disk positions were 70.2°, 66.7°, and 60.1°, respectively. These results suggest that a greater angle of the inferior head of the LPM to the axis of the condyle on axial MRI images may cause medial disk displacement, while a smaller angle may result in lateral disk displacement. (J Oral Sci 58, 29-34, 2016).
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Affiliation(s)
- Kiyomi Kohinata
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
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17
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Yang Z, Wang M, Ma Y, Lai Q, Tong D, Zhang F, Dong L. Magnetic Resonance Imaging (MRI) Evaluation for Anterior Disc Displacement of the Temporomandibular Joint. Med Sci Monit 2017; 23:712-718. [PMID: 28176754 PMCID: PMC5312235 DOI: 10.12659/msm.899230] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) is the criterion standard imaging technique for visualization of the temporomandibular joint (TMJ) region, and is currently considered the optimum modality for comprehensive evaluation in patients with temporomandibular joint disorder (TMD). This study was aimed at finding the value of MRI in pre-clinical diagnosis of TMJ disc displacement. Material/Methods Patients primarily diagnosed as having anterior disc displacement by clinical symptoms and X-ray were selected in the present study. MRI was used to evaluate surrounding anatomical structures and position, as well as morphological and signal intensity change between patients and normal controls. Results Posterior band position was significantly different between the patient group and control group. At the maximum opened-mouth position, the location of disc intermediate zone returned to normal. At closed-mouth position, the thickness of anterior and middle, but not posterior, band increased. The motion range of the condyle in the anterior disc displacement without reduction (ADDWR) patient group was significantly less than the value in the anterior disc displacement with reduction (ADDR) patient group and the control group. Whether at closed-mouth position or maximum opened-mouth position, the exudate volume in the patient group was greater than in the normal group. Conclusions MRI can be successfully used to evaluate multiple morphological changes at different mouth positions of normal volunteers and patients. The disc-condyle relationship can serve as an important indicator in assessing anterior disc displacement, and can be used to distinguish disc displacement with or without reduction.
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Affiliation(s)
- Zhongjun Yang
- Department of Stomatology, The Second Hospital of Shandong University, Jinan, Shandong, China (mainland)
| | - Mingguo Wang
- Department of Stomatology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Yingwei Ma
- Department of Stomatology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Qingguo Lai
- Department of Stomatology, The Second Hospital of Shandong University, Jinan, Shandong, China (mainland)
| | - Dongdong Tong
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Fenghe Zhang
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Lili Dong
- Department of Stomatology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
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18
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Kuhn FP, Spinner G, Del Grande F, Wyss M, Piccirelli M, Erni S, Pfister P, Ho M, Sah BR, Filli L, Ettlin DA, Gallo LM, Andreisek G, Manoliu A. MR imaging of the temporomandibular joint: comparison between acquisitions at 7.0 T using dielectric pads and 3.0 T. Dentomaxillofac Radiol 2016; 46:20160280. [PMID: 27704872 DOI: 10.1259/dmfr.20160280] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To qualitatively and quantitatively compare MRI of the temporomandibular joint (TMJ) at 7.0 T using high-permittivity dielectric pads and 3.0 T using a clinical high-resolution protocol. METHODS Institutional review board-approved study with written informed consent. 12 asymptomatic volunteers were imaged at 7.0 and 3.0 T using 32-channel head coils. High-permittivity dielectric pads consisting of barium titanate in deuterated suspension were used for imaging at 7.0 T. Imaging protocol consisted of oblique sagittal proton density weighted turbo spin echo sequences. For quantitative analysis, pixelwise signal-to-noise ratio maps of the TMJ were calculated. For qualitative analysis, images were evaluated by two independent readers using 5-point Likert scales. Quantitative and qualitative results were compared using t-tests and Wilcoxon signed-rank tests, respectively. RESULTS TMJ imaging at 7.0 T using high-permittivity dielectric pads was feasible in all volunteers. Quantitative analysis showed similar signal-to-noise ratio for both field strengths (mean ± SD; 7.0 T, 13.02 ± 3.92; 3.0 T, 14.02 ± 3.41; two-sample t-tests, p = 0.188). At 7.0 T, qualitative analysis yielded better visibility of all anatomical subregions of the temporomandibular disc (anterior band, intermediate zone and posterior band) than 3.0 T (Wilcoxon signed-rank tests, p < 0.05, corrected for multiple comparisons). CONCLUSIONS MRI of the TMJ at 7.0 T using high-permittivity dielectric pads yields superior visibility of the temporomandibular disc compared with 3.0 T.
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Affiliation(s)
- Felix P Kuhn
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Georg Spinner
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Filippo Del Grande
- 3 Department of Diagnostic and Interventional Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Michael Wyss
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- 4 Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stefan Erni
- 5 Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Pascal Pfister
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Ho
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bert-Ram Sah
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lukas Filli
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik A Ettlin
- 5 Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Luigi M Gallo
- 5 Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Gustav Andreisek
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrei Manoliu
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.,6 Psychiatric University Hospital, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
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19
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Krohn S, Gersdorff N, Wassmann T, Merboldt KD, Joseph AA, Buergers R, Frahm J. Real-time MRI of the temporomandibular joint at 15 frames per second—A feasibility study. Eur J Radiol 2016; 85:2225-2230. [DOI: 10.1016/j.ejrad.2016.10.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 09/05/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
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20
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Digitale Palpation des M. pterygoideus lateralis. MANUELLE MEDIZIN 2016. [DOI: 10.1007/s00337-016-0158-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Bristela M, Schmid-Schwap M, Eder J, Reichenberg G, Kundi M, Piehslinger E, Robinson S. Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results. Clin Oral Investig 2016; 21:237-245. [PMID: 27083157 PMCID: PMC5203833 DOI: 10.1007/s00784-016-1800-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/01/2016] [Indexed: 11/23/2022]
Abstract
Objectives Anterior disk dislocation (ADD) without reposition in the temporomandibular joint (TMJ) may be associated with morphological changes in the retrodiscal region of the bilaminar zone presenting as pseudo-disk (PD). The present study was initiated to investigate the development of retrodiscal fibrosis in a period of 4–8 years and to assess if patients with a PD show differences in the clinical and radiologic findings versus patients without a PD. Materials and Methods In a retrospective follow-up study of 33 consecutive patients with ADD without reposition in one or both TMJs, a clinical and MRI-supported evaluation was conducted 4 to 8 years after baseline diagnosis. Results In 45 % of the TMJs with ADD without reposition, a PD could be identified. Twenty-one of 31 patients who showed pain at the baseline examination (VAS mean 56 ± 38) were pain free. The mouth opening capacity (MO) of the mandible could be increased in 80 %. There were no statistical significant differences between patients with or without PD in these clinical features. The MRI parameters effusion and translation showed a statistical tendency for more improvement in the group with PD (p = 0.061, 0.064). Conclusion In about half of the patients, a structure corresponding to a pseudo-disk developed during follow-up. Pain and the mouth opening capacity improved in all patients independent of the development of a PD. Clinical Relevance Detection of a PD during follow-up of patients with ADD without spontaneous reposition does neither predict favorable nor worse therapy response and clinical course.
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Affiliation(s)
- M Bristela
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria.
| | - M Schmid-Schwap
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | - J Eder
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | | | - M Kundi
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Wien, Austria
| | - E Piehslinger
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | - S Robinson
- Diagnostic Center Urania, Laurenzerberg 2, 1010, Vienna, Austria
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22
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Manoliu A, Spinner G, Wyss M, Filli L, Erni S, Ettlin DA, Ulbrich EJ, Kuhn FP, Gallo LM, Andreisek G. Comparison of a 32-channel head coil and a 2-channel surface coil for MR imaging of the temporomandibular joint at 3.0 T. Dentomaxillofac Radiol 2016; 45:20150420. [PMID: 26837671 DOI: 10.1259/dmfr.20150420] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To quantitatively and qualitatively compare MRI of the temporomandibular joint (TMJ) using a standard TMJ surface coil and a head coil at 3.0 T. METHODS 22 asymptomatic volunteers were MR imaged using a 2-channel surface coil (standard TMJ coil) and a 32-channel head coil at 3.0 T (Philips Ingenia; Philips Healthcare, Netherlands). Imaging protocol consisted of an oblique sagittal proton density weighted turbo spin echo sequence (repetition time/echo time, 2700/26 ms). For quantitative assessment, a spherical phantom was imaged using the same sequence including a noise scan and a B1+ scan. Signal-to-noise ratio (SNR) maps and B1+ maps were calculated on a voxelwise basis. For qualitative evaluation, all volunteers underwent MRI of both TMJs with the jaw in the closed position. Two independent blinded readers assessed accuracy of TMJ anatomical representation and overall image quality on a 5-point scale. Quantitative and qualitative measurements were compared between coils using t-tests and Wilcoxon signed-rank test, respectively. RESULTS Quantitative analysis showed similar B1+ and significantly higher SNR for the head coil than the TMJ surface coil. Qualitative analysis showed significantly better visibility and delineation of clinically relevant anatomical structures of the TMJ, including the articular disc, bilaminar zone and lateral pterygoid muscle. Furthermore, better overall image quality was observed for the head coil than for the TMJ surface coil. CONCLUSIONS A 32-channel head coil is preferable to a standard 2-channel TMJ surface coil when imaging the TMJ at 3.0 T, because it yields higher SNR, thus increasing accuracy of the anatomical representation of the TMJ.
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Affiliation(s)
- Andrei Manoliu
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland.,2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Georg Spinner
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Michael Wyss
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Lukas Filli
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Stefan Erni
- 3 Center of Dental Medicine of the University of Zurich, Zurich, Switzerland
| | - Dominik A Ettlin
- 3 Center of Dental Medicine of the University of Zurich, Zurich, Switzerland
| | - Erika J Ulbrich
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Felix P Kuhn
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Luigi M Gallo
- 3 Center of Dental Medicine of the University of Zurich, Zurich, Switzerland
| | - Gustav Andreisek
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
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23
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El Assar de la Fuente S, Angenete O, Jellestad S, Tzaribachev N, Koos B, Rosendahl K. Juvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review. J Craniomaxillofac Surg 2016; 44:597-607. [PMID: 26924432 DOI: 10.1016/j.jcms.2016.01.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/12/2015] [Accepted: 01/26/2016] [Indexed: 11/29/2022] Open
Abstract
Juvenile idiopathic arthritis is the most common inflammatory rheumatic disease of childhood and represents a series of chronic inflammatory arthritides of unknown cause. Involvement of the temporomandibular joint has been reported in up to 87% of children with juvenile idiopathic arthritis when based on magnetic tomography imaging; it can be asymptomatic and may lead to severe long term complications. In this review a summary of the contemporary literature of imaging of the temporomandibular joint in children with juvenile idiopathic arthritis will be provided, including ultrasound which is a valuable method for guided joint injections, but does not necessarily allow detection of acute inflammation, cone beam computed tomography, which has emerged as a feasible and accurate low-dose alternative as compared to conventional computed tomography to detect destructive change, and magnetic resonance imaging which is considered the method of choice for assessing acute, inflammatory change, although the lack of normative standards remains a challenge in children.
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Affiliation(s)
| | - O Angenete
- Department of Radiology, St Olav University Hospital, Norway
| | - S Jellestad
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - N Tzaribachev
- Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany
| | - B Koos
- Department of Orthodontics, University of Rostock, Germany
| | - K Rosendahl
- Department of Radiology, Haukeland University Hospital, Bergen, Norway; University of Bergen, Department of Clinical Medicine K1, Norway.
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Stelzenmueller W, Umstadt H, Weber D, Goenner-Oezkan V, Kopp S, Lisson J. Evidence - The intraoral palpability of the lateral pterygoid muscle - A prospective study. Ann Anat 2015; 206:89-95. [PMID: 26706107 DOI: 10.1016/j.aanat.2015.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Abstract
The intraoral palpability of the inferior caput of the lateral pterygoid muscle has been a matter of ambiguity because of its topography. Thus, none of the recently published studies has provided reliable proof of the possibility of digital intraoral palpation, although palpation of the muscle is part of most of the examination catalogs for clinical functional analysis and functional therapy. Digital muscle palpation was performed intraorally on five preparations after exposure of the infratemporal fossa and visualization of the lateral pterygoid muscle. Direct digital palpation of the lateral pterygoid muscle was seen in all five cases. The successful palpation was carried out and approved during laterotrusion to the examined side (relaxation). While opening and closing the mouth (contraction) the muscle is palpable. In real-time kinematic measurements (MRI) an impression of the lateral caput of the left lateral pterygoid muscle of a 30-year-old control male person was found up to 6mm. Electromyographic detection by direct signal conduction with concomitant palpation is possible. The injection electrode tested in situ in the muscle was felt transorally with the palpating finger. The intraoral palpability of the inferior caput of the lateral pterygoid muscle is verified. The basic requirement for successfully palpating the lateral pterygoid muscle is the exact knowledge of muscle topography and the intraoral palpation pathway. After documented palpation of the muscle belly in cadaverous preparations, MRI and EMG also visualized palpation of the lateral pterygoid muscle in vivo. The palpation technique seems to be essential and basically feasible.
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Affiliation(s)
- Wolfgang Stelzenmueller
- Universität des Saarlandes, Klinik für Kieferorthopädie, Campus Homburg, Homburg/Saar, Germany.
| | - Horst Umstadt
- CMF-Care GmbH, Practice for Oral and Cranio-Maxillofacial Surgery, Weinheim, Germany
| | - Dominic Weber
- Deutsches Zentrum für Dentaldiagnostik DZD, Frankfurt am Main, Germany
| | | | - Stefan Kopp
- Goethe-Universität Frankfurt, Zentrum der Zahn-, Mund- und Kieferheilkunde (Carolinum), Poliklinik für Kieferorthopädie, Frankfurt am Main, Germany
| | - Jörg Lisson
- Universität des Saarlandes, Klinik für Kieferorthopädie, Campus Homburg, Homburg/Saar, Germany
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Magnetic Resonance Imaging of the Temporomandibular Joint at 7.0 T Using High-Permittivity Dielectric Pads. Invest Radiol 2015; 50:843-9. [DOI: 10.1097/rli.0000000000000196] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tschampa HJ, Urbach H, Malter M, Surges R, Greschus S, Gieseke J. Magnetic resonance imaging of focal cortical dysplasia: Comparison of 3D and 2D fluid attenuated inversion recovery sequences at 3T. Epilepsy Res 2015; 116:8-14. [DOI: 10.1016/j.eplepsyres.2015.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/25/2015] [Accepted: 07/05/2015] [Indexed: 10/23/2022]
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Imaging Approach to Temporomandibular Joint Disorders. Clin Neuroradiol 2015; 26:5-22. [PMID: 26374243 DOI: 10.1007/s00062-015-0465-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 08/31/2015] [Indexed: 12/27/2022]
Abstract
Internal derangement is the most common temporomandibular joint disorder. Degenerative osteoarthritis and trauma are next in frequency. Less common pathology includes rheumatoid arthritis, synovial chondromatosis, calcium pyrophosphate dehydrate deposition disease, pigmented villonodular synovitis, tumors, infection, and osteonecrosis. We provide a systematic approach to facilitate interpretation based on major anatomic structures: disc-attachments, joint space, condyle, and lateral pterygoid muscle. Relevant graphic anatomy and state of the art imaging are discussed in correlation with current clinical and therapeutic highlights of pathologic entities affecting the joint.
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Manoliu A, Spinner G, Wyss M, Erni S, Ettlin DA, Nanz D, Ulbrich EJ, Gallo LM, Andreisek G. Quantitative and qualitative comparison of MR imaging of the temporomandibular joint at 1.5 and 3.0 T using an optimized high-resolution protocol. Dentomaxillofac Radiol 2015; 45:20150240. [PMID: 26371077 DOI: 10.1259/dmfr.20150240] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To quantitatively and qualitatively compare MRI of the temporomandibular joint (TMJ) using an optimized high-resolution protocol at 3.0 T and a clinical standard protocol at 1.5 T. METHODS A phantom and 12 asymptomatic volunteers were MR imaged using a 2-channel surface coil (standard TMJ coil) at 1.5 and 3.0 T (Philips Achieva and Philips Ingenia, respectively; Philips Healthcare, Best, Netherlands). Imaging protocol consisted of coronal and oblique sagittal proton density-weighted turbo spin echo sequences. For quantitative evaluation, a spherical phantom was imaged. Signal-to-noise ratio (SNR) maps were calculated on a voxelwise basis. For qualitative evaluation, all volunteers underwent MRI of the TMJ with the jaw in closed position. Two readers independently assessed visibility and delineation of anatomical structures of the TMJ and overall image quality on a 5-point Likert scale. Quantitative and qualitative measurements were compared between field strengths. RESULTS The quantitative analysis showed similar SNR for the high-resolution protocol at 3.0 T compared with the clinical protocol at 1.5 T. The qualitative analysis showed significantly better visibility and delineation of clinically relevant anatomical structures of the TMJ, including the TMJ disc and pterygoid muscle as well as better overall image quality at 3.0 T than at 1.5 T. CONCLUSIONS The presented results indicate that expected gains in SNR at 3.0 T can be used to increase the spatial resolution when imaging the TMJ, which translates into increased visibility and delineation of anatomical structures of the TMJ. Therefore, imaging at 3.0 T should be preferred over 1.5 T for imaging the TMJ.
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Affiliation(s)
- Andrei Manoliu
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Georg Spinner
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Michael Wyss
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Stefan Erni
- 3 Center of Dental Medicine of the University of Zurich, Zurich, Switzerland
| | - Dominik A Ettlin
- 3 Center of Dental Medicine of the University of Zurich, Zurich, Switzerland
| | - Daniel Nanz
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Erika J Ulbrich
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Luigi M Gallo
- 3 Center of Dental Medicine of the University of Zurich, Zurich, Switzerland
| | - Gustav Andreisek
- 1 Department of Radiology, Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Assaf AT, Zrnc TA, Remus CC, Khokale A, Habermann CR, Schulze D, Fiehler J, Heiland M, Sedlacik J, Friedrich RE. Early detection of pulp necrosis and dental vitality after traumatic dental injuries in children and adolescents by 3-Tesla magnetic resonance imaging. J Craniomaxillofac Surg 2015; 43:1088-93. [PMID: 26165761 DOI: 10.1016/j.jcms.2015.06.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/22/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES More than 50% of all children suffer a traumatic dental injury (TDI) during childhood. In many cases, dentists apply root canal treatment (RCT), which is performed on an average of 7-10 days after replantation. Our aim was to evaluate whether RCT is necessary in many cases, and whether revitalization of affected teeth is possible and measurable by visualization using 3T magnetic resonance imaging (MRI). MATERIAL AND METHODS Seven healthy children with TDI were treated by repositioning of the affected teeth and reduction of alveolar process fractures followed by splinting. Two weeks after initial treatment, splints were removed. After 6 weeks, all children received 3-Tesla (3T), three-dimensional, high-resolution MRI with a 20-channel standard head and neck coil. The mean age of the children (male/female = 5:2) was 10.8 years (range, 8-17 years). In addition, all children received conventional dental examination for tooth vitality and dental sensitivity to cold and tenderness on percussion. RESULTS 3T MRI provided excellent images that allowed fine discrimination between dental pulp and adjacent tooth. Using four in-house optimized, non-contrast-enhanced sequences, including panoramic reconstruction, the assessment and analysis of the dental pulp was sufficiently feasible. We could demonstrate reperfusion and thus vitality of the affected teeth in 11 sites. In one child, MRI was able to detect nonreperfusion after TDI of the affected tooth. MRI results were confirmed by clinical examination in all cases. As a consequence of this expectant management and proof of reperfusion and tooth vitality by 3T MRI, only one child had to be treated by RCT. CONCLUSION 3T MRI is a very promising tool for visualization and detection in the field of dental and oromaxillofacial diseases. By using new 3T MRI sequences in children with TDI, we could demonstrate that RCT are not necessary in every case, and thus could prevent unnecessary treatment of children in the future. Larger studies should follow to confirm the potential benefit in clinical practice.
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Affiliation(s)
- Alexandre T Assaf
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland, MD, DMD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany.
| | - Tomislav A Zrnc
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Dr. H.F. Zeilhofer, MD, DMD, PhD), University Hospital Basel, University of Basel, Spitalstr. 21, 4056 Basel, Switzerland
| | - Chressen C Remus
- Department for Diagnostics and Interventional Radiology (Head: Prof. Dr. G. Adam, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 78, 20246 Hamburg, Germany
| | - Arun Khokale
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Christian R Habermann
- Department for Diagnostics and Interventional Radiology (Head: Dr. H. Denkhaus, MD), Marien Hospital Hamburg, Alfredstraße 9, 22087 Hamburg, Germany
| | - Dirk Schulze
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland, MD, DMD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Jan Sedlacik
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland, MD, DMD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
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Nadershah M, Mehra P. Orthognathic Surgery in the Presence of Temporomandibular Dysfunction. Oral Maxillofac Surg Clin North Am 2015; 27:11-26. [DOI: 10.1016/j.coms.2014.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sensitivity of quantitative UTE MRI to the biomechanical property of the temporomandibular joint disc. Skeletal Radiol 2014; 43:1217-23. [PMID: 24878837 PMCID: PMC4349555 DOI: 10.1007/s00256-014-1901-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/05/2014] [Accepted: 04/23/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE To quantify MR properties of discs from cadaveric human temporomandibular joints (TMJ) using quantitative conventional and ultrashort time-to-echo magnetic resonance imaging (UTE MRI) techniques and to corroborate regional variation in the MR properties with that of biomechanical indentation stiffness. METHODS This study was exempt from the institutional review board approval. Cadaveric (four donors, two females, 74 ± 10.7 years) TMJs were sliced (n = 14 slices total) sagittally and imaged using quantitative techniques of conventional spin echo T2 (SE T2), UTE T2*, and UTE T1rho. The discs were then subjected to biomechanical indentation testing, which is performed by compressing the tissue with the blunt end of a small solid cylinder. Regional variations in MR and indentation stiffness were correlated. TMJ of a healthy volunteer was also imaged to show in vivo feasibility. RESULTS Using the ME SE T2 and the UTE T1rho techniques, a significant (each p < 0.0001) inverse relation between MR and indentation stiffness properties was observed for the data in the lower range of stiffness. However, the strength of correlation was significantly higher (p < 0.05) for UTE T1rho (R(2) = 0.42) than SE T2 (R(2) = 0.19) or UTE T2* (R(2) = 0.02, p = 0.1) techniques. CONCLUSION The UTE T1rho technique, applicable in vivo, facilitated quantitative evaluation of TMJ discs and showed a high sensitivity to biomechanical softening of the TMJ discs. With additional work, the technique may become a useful surrogate measure for loss of biomechanical integrity of TMJ discs reflecting degeneration.
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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; 43:20130387. [PMID: 24720606 DOI: 10.1259/dmfr.20130387] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this prospective study was to compare dynamic and static sequences in the evaluation of temporomandibular joint disorders using a 3.0 -T imaging unit. METHODS 194 patients were evaluated by static (double echo proton density weighted/turbo spin echo T2 weighted sequences) and dynamic (half-Fourier single-shot turbo spin echo sequences)imaging. Two radiologists evaluated in consensus the quality of images, the disc position and morphological alterations. The Kendall rank correlation coefficient (τ-b) was used to compare the qualitative rating between static and dynamic sequences. Cohen's kappa coefficient (k) was used to assess the agreement of disc position and morphological alterations between both sequences. The intraclass correlation coefficient was used to calculate the intraobserver variability. The significance was set at p ≤ 0.05. RESULTS The correlation between both sequences in the qualitative evaluation was τ-b = 0.632. The agreement between both techniques in the evaluation of disc position was k = 0.856. The agreement between both techniques in assessing the morphological alterations was k = 0.487. In the static sequences, the intraclass correlation coefficient was 0.915 in the qualitative evaluation, 0.873 in the evaluation of disc position and 0.934 in the assessment of morphological alterations. In the dynamic sequences, the intraclass correlation coefficient was 0.785 in the qualitative evaluation, 0.935 in the evaluation of disc position and 0.826 in the assessment of morphological alterations. CONCLUSIONS Static imaging remains the gold standard in the evaluation of the temporomandibular joint. Dynamic imaging is a valuable tool that can provide additional information about topographic changes in the disc-condyle relationship.
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Affiliation(s)
- M Cassetta
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy
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Assaf AT, Zrnc TA, Remus CC, Schönfeld M, Habermann CR, Riecke B, Friedrich RE, Fiehler J, Heiland M, Sedlacik J. Evaluation of four different optimized magnetic-resonance-imaging sequences for visualization of dental and maxillo-mandibular structures at 3 T. J Craniomaxillofac Surg 2014; 42:1356-63. [PMID: 24837485 DOI: 10.1016/j.jcms.2014.03.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 02/11/2014] [Accepted: 03/25/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate four in-house optimized, non-contrast enhanced sequences for MRI-investigation of maxillo-mandibular and dental structures by use of 3 T. METHODS 12 volunteers with different dental status were examined by using a 3 T MRI with a 20-channel standard head-and-neck coil. All images performed were evaluated by using 3D-techniques, with different slice-thicknesses, in 3D T1- and T2-weighted sequences, as well as by using new techniques of image depictions. In addition phantom measurements were performed to estimate the extent of image artefacts caused by retainers and metal implants. RESULTS Mean age of the participants was 33 years (range, 25.5-62.75 years), and the sex ratio was 5 females to 7 males. We identified different techniques to improve osseous and dental structures, despite problems caused by dental implants, tooth crowns or braces. CONCLUSION The sequences evaluated offered excellent visualization in 2D and 3D of osseous and dental structures. Anatomical, osseous and dental structures were described at their ROI, in relation to patients with dental and head and neck pathologies. The ability to detect and distinguish pathological processes as soon as possible in 3D with excellent image quality avoiding ionizing radiation remains a challenging domain.
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Affiliation(s)
- Alexandre T Assaf
- Department of Oral and Maxillofacial Surgery (Head: Prof. MD, DMD, PhD. Max Heiland), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany.
| | - Tomislav A Zrnc
- Department of Oral and Maxillofacial Surgery (Head: Prof. MD, DMD, PhD. Max Heiland), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Chressen C Remus
- Department of Diagnostics and Interventional Radiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Michael Schönfeld
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. MD, PhD. Jens Fiehler), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Christian R Habermann
- Department of Diagnostics and Interventional Radiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Björn Riecke
- Department of Oral and Maxillofacial Surgery (Head: Prof. MD, DMD, PhD. Max Heiland), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery (Head: Prof. MD, DMD, PhD. Max Heiland), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. MD, PhD. Jens Fiehler), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery (Head: Prof. MD, DMD, PhD. Max Heiland), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Jan Sedlacik
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. MD, PhD. Jens Fiehler), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
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Ottl P, Hohmann A, Piwowarczyk A, Hardenacke F, Lauer HC, Zanella F. Retrospective Study on the Evaluation of the TMJ by MRI Using a Newly Developed Standardized Evaluation Form. Cranio 2014; 26:33-43. [DOI: 10.1179/crn.2008.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Schmid-Schwap M, Bristela M, Pittschieler E, Skolka A, Szomolanyi P, Weber M, Piehslinger E, Trattnig S. Biochemical analysis of the articular disc of the temporomandibular joint with magnetic resonance T2 mapping: a feasibility study. Clin Oral Investig 2013; 18:1865-71. [PMID: 24306680 DOI: 10.1007/s00784-013-1154-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Symptoms of temporomandibular joint (TMJ) dysfunction can seriously compromise patients' quality of life. The aim of our study was to use magnetic resonance imaging (MRI) T2 mapping of the articular disc to determine whether T2 mapping of the TMJ disc is feasible in routine clinical imaging and to assess the normal T2 relaxation time distribution within the TMJ. METHODS Included were ten asymptomatic volunteers without pain, any mouth-opening limitations, or any clicking phenomena. MR imaging was performed on a 3-T MR scanner using a flexible, dedicated, eight-channel multielement coil. T2 mapping was performed in the oblique sagittal plane. The regions of interest (ROIs) for the T2 relaxation time maps of the disc were selected manually. RESULTS The mean values for ROIs ranged between 22.4 and 28.8 ms, and the mean for all ROIs was 26.0 ± 5.0 ms. Intraclass correlation (ICC) for interobserver variability was 0.698, and ICC for intraobserver variability was 0.861. There was no statistically significant difference between raters (p = 0.091) or sides (p = 0.810). CONCLUSION The T2 mapping technique enables ultrastructural analysis of the composition of TMJ disc. This biochemical technique is feasible in vivo, as shown in our study, when a high-field (3 T) MR and a dedicated TMJ coil are used. CLINICAL RELEVANCE T2 mapping as a biochemical technique, together with morphological MRI, may help to gain more insights into the physiology and into the pathophysiology of the articular disc in the TMJ noninvasively and in vivo.
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Affiliation(s)
- Martina Schmid-Schwap
- Department of Prosthodontics, Bernhard Gottlieb University of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria,
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Galhardo APM, Baracat EC, da Costa Leite C, Gebrim EMMS, Gomes RLE, Mukai MK, Mori M, Gil C. Characteristics related to TMJ arthralgia, visualized by magnetic resonance imaging (3.0 Tesla). J Prosthodont Res 2013; 57:298-303. [PMID: 24128391 DOI: 10.1016/j.jpor.2013.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 08/01/2013] [Accepted: 08/23/2013] [Indexed: 10/26/2022]
Abstract
PATIENTS Six women, with ages ranging from 52 to 64 years old, clinically evaluated (Research Diagnostic Criteria for Temporomandibular Disorders) by a single examiner were submitted to MRI (3.0 T). They had only arthralgia diagnosis. The images were evaluated by two radiologists who were not informed about the patients' clinical conditions, in which discs displacements, osteophytes and morphological irregularities, as well as completely normal images, i.e., without any characteristics were identified. DISCUSSION TMJ arthralgia can be caused by various conditions, few of which are objectively observed when investigating its causes or diagnose temporomandibular disorders (TMD). In some cases, imaging exams can detect some conditions and magnetic resonance imaging (MRI) is commonly used for this purpose. Here, the MRI (3.0 T) enabled a detailed visualization of the structures of the TMJ, allowing the characterization of the symptomology in some cases. Despite, some images were completely normal. CONCLUSION This case report detected some features seen on the MRI that justified a clinical diagnosis arthralgia, not associated with other clinical diagnosis. However, the detailed clinical examination should be sovereign even in the face of equipment with advanced technology.
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Matsumoto K, Kameoka S, Amemiya T, Yamada H, Araki M, Iwai K, Hashimoto K, Honda K. Discrepancy of coronal morphology between mandibular condyle and fossa is related to pathogenesis of anterior disk displacement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:626-32. [PMID: 24012352 DOI: 10.1016/j.oooo.2013.06.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/18/2013] [Accepted: 06/21/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate whether morphological discrepancy between the mandibular condyle and fossa of the temporomandibular joint (TMJ) is related to disk displacement on magnetic resonance imaging (MRI). STUDY DESIGN This study included 61 patients with unilateral internal derangement based on both MRI and clinical examination. Coronal morphologies of the condyle and fossa were divided into four groups based on Öberg's classification. According to the coronal morphology of the condyle and fossa, all joints were dichotomized into either harmonized group or a discrepancy group (e.g., angled condyle and concave fossa). The incidence of discrepancy and the relationship of the discrepancy to other findings on MRI were statistically evaluated. RESULTS The discrepancy had a significantly higher incidence on the affected side. The discrepancy correlated with incidence of disk deformity on the affected side. CONCLUSION Morphological discrepancy between the condyle and fossa is related to development of anterior disk displacement in the TMJ.
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Affiliation(s)
- Kunihito Matsumoto
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, Tokyo, Japan.
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Galhardo APM, da Costa Leite C, Gebrim EMMS, Gomes RLE, Mukai MK, Yamaguchi CA, Bernardo WM, Soares JM, Baracat EC, Gil C. The correlation of research diagnostic criteria for temporomandibular disorders and magnetic resonance imaging: a study of diagnostic accuracy. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:277-84. [PMID: 23312922 DOI: 10.1016/j.oooo.2012.10.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 09/07/2012] [Accepted: 10/24/2012] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the performance of research diagnostic criteria for temporomandibular disorders (RDC/TMD) as a diagnostic test for temporomandibular joint problems using magnetic resonance imaging (MRI) as the gold standard. STUDY DESIGN Sixty-seven women were assessed with RDC/TMD (2 examiners) and underwent MRI examination (3.0 T). Images were evaluated by 2 independent radiologists blinded to the clinical diagnoses. Results were analyzed by the Catmaker system. RESULTS Of the 67 patients, 44 were diagnosed with temporomandibular disorders (TMD) according to RDC/TMD, but 21 (32%) of the diagnoses were not confirmed by MRI. The RDC/TMD sensitivity was 83.0%, specificity was 53.0%, and the positive likelihood ratio was 1.77, whereas the negative likelihood ratio was 0.32 (P = 0.16). CONCLUSIONS Our data suggest that RDC/TMD is a good research tool, but the high rate of false-positive results limits its use in clinical practice.
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Loading of the knee during 3.0T MRI is associated with significantly increased medial meniscus extrusion in mild and moderate osteoarthritis. Eur J Radiol 2013; 81:1839-45. [PMID: 21684704 DOI: 10.1016/j.ejrad.2011.05.027] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 05/09/2011] [Accepted: 05/10/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE Standard knee MRI is performed under unloading (ULC) conditions and not much is known about changes of the meniscus, ligaments or cartilage under loading conditions (LC). The aim is to study the influence of loading of different knee structures at 3Tesla (T) in subjects with osteoarthritis (OA) and normal controls. MATERIALS AND METHODS 30 subjects, 10 healthy and 20 with radiographic evidence of OA (10 mild and 10 moderate) underwent 3T MRI under ULC and LC at 50% body weight. All images were analyzed by two musculoskeletal radiologists identifying and grading cartilage, meniscal, ligamentous abnormalities. The changes between ULC and LC were assessed. For meniscus, cartilage and ligaments the changes of lesions, signal and shape were evaluated. In addition, for the meniscus changes in extrusion were examined. A multivariate regression model was used for correlations to correct the data for the impact of age, gender, BMI. A paired T-Test was performed to calculate the differences in meniscus extrusion. RESULTS Subjects with degenerative knee abnormalities demonstrated significantly increased meniscus extrusion under LC when compared to normal subjects (p=0.0008-0.0027). Subjects with knee abnormalities and higher KL scores showed significantly more changes in lesion, signal and shape of the meniscus (80% (16/20) vs. 20% (2/10); p=0.0025), ligaments and cartilage during LC. CONCLUSION The study demonstrates that axial loading has an effect on articular cartilage, ligament, and meniscus morphology, which is more significant in subjects with degenerative disease and may serve as an additional diagnostic tool for disease diagnosis and assessing progression in subjects with knee OA.
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Cao Y, Xia C, Wang S, He S, Wamalwa P, Chen S. Application of magnetic resonance T2 mapping in the temporomandibular joints. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:644-9. [DOI: 10.1016/j.oooo.2012.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 05/25/2012] [Accepted: 05/30/2012] [Indexed: 11/15/2022]
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MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference. Eur Radiol 2012; 22:1579-85. [DOI: 10.1007/s00330-012-2391-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 12/05/2011] [Accepted: 12/21/2011] [Indexed: 10/14/2022]
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Carl M, Sanal HT, Diaz E, Du J, Girard O, Statum S, Znamirowski R, Chung CB. Optimizing MR signal contrast of the temporomandibular joint disk. J Magn Reson Imaging 2011; 34:1458-64. [PMID: 21972123 DOI: 10.1002/jmri.22810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 08/12/2011] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To use a tissue specific algorithm to numerically optimize UTE sequence parameters to maximize contrast within temporomandibular joint (TMJ) donor tissue. MATERIALS AND METHODS A TMJ specimen tissue block was sectioned in a true sagittal plane and imaged at 3 Tesla (T) using UTE pulse sequences with dual echo subtraction. The MR tissue properties (PD, T(2) , T(2) *, and T(1) ) were measured and subsequently used to calculate the optimum sequences parameters (repetition time [TR], echo time [TE], and θ). RESULTS It was found that the main contrast available in the TMJ could be obtained from T(2) (or T(2) *) contrast. With the first echo time fixed at 8 μs and using TR = 200 ms, the optimum parameters were found to be: θ ≈ 60°, and TE2 ≈ 15 ms, when the second echo is acquired using a gradient echo and θ ≈ 120°, and TE2 ≈ 15 ms, when the second echo is acquired using a spin echo. CONCLUSION Our results show that MR signal contrast can be optimized between tissues in a systematic manner. The MR contrast within the TMJ was successfully optimized with facile delineation between disc and soft tissues.
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Magnetic resonance imaging of the temporomandibular joint in the rat compared with low-powered light microscopy. Arch Oral Biol 2011; 56:1382-9. [PMID: 21549351 DOI: 10.1016/j.archoralbio.2011.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 03/07/2011] [Accepted: 03/31/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE High magnetic field magnetic resonance imaging (MRI) was applied to the temporomandibular joint (TMJ) in the rat. The purpose of this study was the depiction of the internal structure of the TMJ, including the articular disc, articular cartilage, and the upper and lower joint cavities. We also proposed MRI settings and slices suitable for imaging the TMJ in the rat. METHODS Temporomandibular joints from one female and eight male Sprague Dawley rats (5-8 weeks old) and four male Wistar-Hamamatsu rats (7-8 weeks old) were used. Using scout images, the horizontal plane was defined as being parallel to the body of the basisphenoid bone underneath the base of the brain. The coronal plane was defined as a slice vertical to the horizontal plane and vertical to the longitudinal fissure of the cerebrum. The sagittal plane was defined as a slice vertical to the horizontal plane and parallel to the longitudinal fissure of the cerebrum. RESULTS T(1)-weighted MR images with a spatial resolution of 75 μm were obtained for 5 min. The temporal bone and mandibular condyle were depicted as lower signal intensity images and the articular disc was depicted as an intermediate signal intensity image. In accordance with Gd-DTPA-enhanced MR or T(2)-weighted MR images, the articular disc, articular cartilage, and the upper and lower joint cavities could be assigned clearly. CONCLUSION These MRI findings closely agreed with those observed with haematoxylin-eosin staining under light microscopy, suggesting that MRI is a useful method for analyzing the complex structure of the TMJ in the rat.
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Iwasaki H, Kubo H, Harada M, Nishitani H. Temporomandibular joint and 3.0 T pseudodynamic magnetic resonance imaging. Part 1: evaluation of condylar and disc dysfunction. Dentomaxillofac Radiol 2011; 39:475-85. [PMID: 21062941 DOI: 10.1259/dmfr/29741224] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study describes an improved method for examining and diagnosing temporomandibular joint (TMJ) dynamics by 3.0 T pseudodynamic MRI. METHODS Clinical observation and conventional static MRI of volunteers (one without and eight with TMJ arthrosis) were followed by 3.0 T pseudodynamic MRI in positions ranging from the mouth closed to mouth fully opened. Condylar head (Cd), articular disc anterior border (Da) and articular disc posterior border (Dp) were digitized on sagittal images to determine trajectory and velocity patterns. RESULTS Patients were divided into three groups based on the presence or absence of dysfunction: Group 1, no dysfunction on the right or left side of the TMJ; Group 2, dysfunction on the right or left side of the TMJ; and Group 3, dysfunction on both the right and left sides of the TMJs. In 75% of patients (12 of 16 joints), pseudodynamic TMJ analysis was useful for determining a functional abnormality. Using a points system based on three trajectory and seven velocity patterns, discs with adhesion and perforation had significantly fewer points than discs with anterior displacement (with and without reduction) and discs with no abnormality (P = 0.019 < 0.05). CONCLUSIONS Trajectory and velocity patterns based on 3.0 T pseudodynamic MRI identified the affected side and determined the extent of morbidity in the Cd as well as the Da and Dp. The typical abnormal movement pattern of discs with anterior displacement (with and without reduction) and pathological structural changes of the articular disc (such as adhesion and perforation) could be identified.
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Affiliation(s)
- H Iwasaki
- Department of Oral and Maxillofacial Radiology, Institute of Health Bioscience (IHBS), The University of Tokushima Graduate School, 18-15 Kuramoto-3-Chome, Tokushima 770-8504, Japan.
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Alkhader M, Ohbayashi N, Tetsumura A, Nakamura S, Okochi K, Momin MA, Kurabayashi T. Diagnostic performance of magnetic resonance imaging for detecting osseous abnormalities of the temporomandibular joint and its correlation with cone beam computed tomography. Dentomaxillofac Radiol 2010; 39:270-6. [PMID: 20587650 DOI: 10.1259/dmfr/25151578] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE With cone beam CT (CBCT) as the reference standard, the objective of this study was to determine the diagnostic accuracy of MRI for assessing osseous abnormalities of the temporomandibular joint (TMJ). METHODS 106 TMJs from 55 patients with temporomandibular disorder were examined by CBCT and MRI. CBCT images were evaluated by two experienced oral radiologists with regard to the presence or absence of each of the following eight types of osseous abnormalities: Type 1, destructive and erosive osseous changes of the condyle; Type 2, flattening of the articular surface of the condyle; Type 3, deformity of the condyle; Type 4, sclerosis of the condyle; Type 5, osteophyte formation; Type 6, ankylosis; Type 7, erosion of the articular fossa and/or eminence; and Type 8, sclerosis of the articular fossa and/or eminence. For detection of these osseous abnormalities by MRI, proton density-weighted images and T(2) weighted images were evaluated independently by three observers. Using CBCT findings as the reference standard, the diagnostic performance of MRI for detecting various types of osseous abnormalities was evaluated by calculating its sensitivity and specificity. RESULTS Out of 106 joints, CBCT revealed Types 1, 2, 3, 4, 5, 6, 7 and 8 abnormalities in 25, 19, 26, 20, 14, 5, 19 and 22 joints, respectively. The mean sensitivities of MRI among the three observers for detecting Types 1, 2, 3, 4, 5, 6, 7 and 8 abnormalities were 61%, 30%, 82%, 40%, 48%, 34%, 61% and 41%, respectively, whereas the mean specificities were 86%, 92%, 91%, 95%, 84%, 98%, 89% and 91%, respectively. CONCLUSIONS Although high specificity (84-98%) was obtained with MRI, this modality showed relatively low sensitivity (30-82%) for detecting osseous abnormalities of the TMJ. The value of MRI for the detection of TMJ osseous abnormalities is considered to be limited.
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Affiliation(s)
- M Alkhader
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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Isotropic 3-dimensional fast spin echo imaging versus standard 2-dimensional imaging at 3.0 T of the knee: artificial cartilage and meniscal lesions in a porcine model. J Comput Assist Tomogr 2010; 34:260-9. [PMID: 20351518 DOI: 10.1097/rct.0b013e3181c20f6d] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare different fat-saturated (FS) 3-dimensional (3D) intermediate-weighted (IM-w) fast spin echo (FSE) sequences with a standard FS 2-dimensional (2D) IM-w FSE sequence using a porcine in vitro model with artificially created cartilage and meniscus lesions. METHODS Using a ceramic scalpel, cartilage lesions with different depths and sizes were created in porcine knee specimens at the patella as well as the medial and lateral femoral and tibial cartilage. In addition, lateral and medial meniscal lesions were produced. Magnetic resonance imaging was performed at 3.0 T in sagittal plane using an 8-channel knee coil. A standard FS 2D IM-w FSE sequence and 3 newly developed isotropic 3D FSE sequences: (i) non-FS echo train length (ETL): 78, (ii) FS ETL: 44, and (iii) FS ETL: 44, were used. The images were independently analyzed by 4 radiologists concerning image quality (1 = optimal image quality, 4 = substantially limited quality) and absence or presence of lesions using a 5-level confidence score (1 = definite no presence of abnormality, 5 = definite presence of abnormality). Radiologists were also asked to measure diameter and categorize the depth of cartilage lesions using a modified Noyes classification. Average scores for image quality, confidence of diagnosis, and sensitivity, specificity, and accuracy were calculated. In addition, contrast-to-noise ratios were calculated. RESULTS Image quality was significantly (P < 0.05) lower on the 3D FSE images than on the 2D FSE images [3D (i): 1.6 (SD, 0.43); 3D (ii): 2.35 (SD, 0.7); 3D (iii): 2.35 (SD, 0.5); 2D: 1.3 (SD, 0.35)]. No significant differences in diagnostic performance were found between 3D (i) and 2D FSE sequences. However, 16% fewer lesions were correctly detected with the 3D (ii) and (iii) sequences. Sensitivity was highest for the 2D sequence, and specificity was highest for the 3D (i) sequence. Confidence scores were higher for the 3D (i) sequence than for the 2D sequence. A significant increase (P < 0.05) in correctly measured cartilage lesions size and depth was found for the 3D (i) sequence over the standard 2D FSE sequence. CONCLUSIONS Although the 3D FSE sequence performed better in depiction and characterization of cartilage abnormalities than the standard 2D FSE sequence, we currently do not recommend to use it as substitute. For the diagnosis of meniscal defects, however, no significant improvement was found.
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RODRÍGUEZ MJ, AGUT A, SOLER M, LÓPEZ-ALBORS O, ARREDONDO J, QUEROL M, LATORRE R. Magnetic resonance imaging of the equine temporomandibular joint anatomy. Equine Vet J 2010; 42:200-7. [DOI: 10.1111/j.2042-3306.2010.00030.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, John MT, Schiffman EL. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. ACTA ACUST UNITED AC 2009; 107:844-60. [PMID: 19464658 DOI: 10.1016/j.tripleo.2009.02.023] [Citation(s) in RCA: 413] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 12/17/2008] [Accepted: 02/09/2009] [Indexed: 01/05/2023]
Abstract
OBJECTIVE As part of the Multisite Research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) Validation Project, comprehensive temporomandibular joint diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computerized tomography (CT). STUDY DESIGN Interexaminer reliability was estimated using the kappa (kappa) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. Computerized tomography was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA). RESULTS For the radiologic diagnosis of OA, reliability of the 3 examiners was poor for panoramic radiography (kappa = 0.16), fair for MRI (kappa = 0.46), and close to the threshold for excellent for CT (kappa = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (kappa = 0.78) and for DD without reduction (kappa = 0.94) and good for effusion (kappa = 0.64). Overall percent agreement for pairwise ratings was >or=82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and of effusion was 81%. Negative percent agreement was >or=88% for all conditions. Compared with CT, panoramic radiography and MRI had poor and marginal sensitivity, respectively, but excellent specificity in detecting OA. CONCLUSION Comprehensive image analysis criteria for the RDC/TMD Validation Project were developed, which can reliably be used for assessing OA using CT and for disc position and effusion using MRI.
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Affiliation(s)
- Mansur Ahmad
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota 55455, USA.
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High-resolution magnetic resonance imaging of triangular fibrocartilage complex lesions in acute wrist trauma: image quality at different field strengths. J Comput Assist Tomogr 2009; 33:579-83. [PMID: 19638854 DOI: 10.1097/rct.0b013e31818c093a] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purposes of this study were to assess the diagnostic capacity of a new high-resolution imaging protocol for the wrist and triangular fibrocartilage complex (TFCC) lesions at 3.0 T and to compare it with our established 1.5-T protocol. MATERIALS AND METHODS Twenty-one patients with an acute wrist trauma were examined at a 3.0-T imaging system and agreed to undergo an additional examination at 1.5 T. Magnetic resonance imaging was performed with 1.5-T (standard wrist coil) and 3.0-T (purpose-build phased-array coil) imaging system, using coronal T1-weighted turbo-spin-echo, proton density-weighted fat-saturated, and coronal and axial contrast-enhanced T1-weighted gradient-echo fat-saturated sequences, with reduced voxel size from 0.50 x 0.50 x 3.0 mm (1.5 T) to 0.20 x 0.20 x 1.5 mm (3.0 T). For qualitative analysis, 2 observers assessed in consensus delineation, image quality, and artifacts in anatomical landmarks (cartilage, TFCC, and TFCC lesion) and ranked them on a 5-point scale from 1 (nondiagnostic) to 5 (optimal). For quantitative analysis, measurements of the contrast-to-noise ratio were obtained between disk and surrounding tissue. RESULTS All parts of the TFCC and TFCC lesions (n = 14) were seen significantly better at 3.0 T (mean [SD], 4.6 [0.5] vs 2.6 [1.2], P < 0.0001), with higher ranked overall image quality. In 3 cases, TFCC lesions were seen only at 3.0 T. Proton density-weighted fat-saturated sequence had significantly more artifacts at 3.0 T (2.5 [0.6] vs 1.9 [0.5], P < 0.001) in contrast to T1 sequences. Quantitative evaluation showed significantly higher contrast-to-noise ratio for 3.0 T (5.0 [1.1] vs 3.9 [0.9], P < 0.0001). CONCLUSION Depiction of anatomy and pathology of the TFCC benefits significantly from 3.0-T imaging when higher signal-to-noise ratio is invested into improved spatial resolution. Especially small lesions of the disk were detected only or better at 3.0 T.
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