Magnetic resonance imagine of the temporomandibular joint: Value of pseudodynamic images

Author(s): Westesson, P. L., Isberg, A.

Journal/Book: Oral Surg Oral Med Oral Patho. 1996; 81: 11830 Westline Industrial Dr, St Louis, MO 63146-3318. Mosby-Year Book Inc. 110-123.

Abstract: Magnetic resonance fast scanning technique (gradient recalled acquisition at steady state) has been reported to be useful when evaluating the dynamics of the temporomandibular joint and also to be accurate for determining the disk position. Yet in our clinical experience gradient reca;!led acquisition at steady state images have frequently been inferior to proton density images for diagnosis of temporomandibular joint internal derangement. The first aim of this study was to compare gradient recalled acquisition at steady state images with proton density images for diagnosis of disk position. The second aim was to identify what additional information could he gathered from gradient recalled acquisition at steady state images when compared with static proton density images. We obtained unilateral images from 20 patients with sign; and symptoms of temporomandibular joint internal derangement and from 20 asymptomatic volunteers. Multiple gradient recalled acquisition at steady state images were obtained during mouth opening and closing and proton density images were obtained at the closed and open mouth positions. The results showed that the gradient recalled acquisition at steady state images were in accordance with the proton density images in 32 joints (80%) and were false negative in 8 joints (20%). Six of the joints with false-negative gradient recalled acquisition at steady slate images showed sideways disk displacement, and two showed partial anterior disk displacement. Gradient recalled acquisition at steady state images, on-the-other hand, provided information about movement pattern and also demonstrated impingement of the joint structures on the muscles anterior to the joint at maximal mouth opening. It was concluded that gradient recalled acquisition at steady state images cannot replace proton density images for diagnosis of disk position but they can provide supplementary information for evaluation of joint function.

Note: Article A Isberg, Umea Univ, Sch Dent, Dept Oral & Maxillofacial Radiol, S-90187 Umea, Sweden

Keyword(s): INTERNAL DERANGEMENTS; DISK DISPLACEMENT; MR; TMJ

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