The diagnostic utility of dynamic Magnetic Resonance Imaging in temporomandibular joint internal derangements.

Congress:

2019 ASM

Poster Number:

R-0096

Type:

Educational Exhibit

Keywords:

Musculoskeletal joint, MR physics, Anatomy, MR, Imaging sequences, Education and training

Authors:

I. Fomin, W. Boal, T. Watkins, S. Bhuta, C. Chia-Tsong Hsu; QLD/AU

DOI:

10.26044/ranzcr2019/R-0096

DOI-Link:

https://dx.doi.org/10.26044/ranzcr2019/R-0096

Fig. 1: Figure 1: Sagittal-oblique PD images of TMJ demonstrate normal condylar disc...

Fig. 2: Figure 2: Sagittal-oblique PD images of TMJ demonstrate normal condylar disc...

Fig. 4: Figure 4: Normal coronal anatomy showing articular disk (AD), mandibular...

Fig. 5: Figure 5: Oblique sagittal PD performed in open and closed mouth position...

Learning objectives

To review the diagnostic utility of the fast imaging with steady-state free precession (true-FISP) MRI sequence in the diagnosis of articular disc disease of the temporomandibular joints (TMJ).

Background

The temporomandibular joint dysfunction is a debilitating condition with a prevalence of 5-12% and predilection for adolescents and young females[1,3].Articular disc disease of the TMJ is defined as abnormal position and relationship between the disc, mandibular condyle and articular eminence[1]. The true FISP MRI sequence complements conventional studies through the acquisition of additional information aboutarticular disc mobility and reduction. The educational exhibit aims to review the true-FISP CINE MRI TMJ sequence and determine its diagnostic value in assessment of biomechanical dysfunctions of the TMJ.

Imaging findings OR Procedure details

The conventional static TMJ MRI is performed in the close and open mouth positions and usually demonstrates good anatomical relationships of thecondyle-disc complex, with 95% accuracy in the determination of the articular disc position[3]. Figures 1 and 2 demonstrate normal anatomy of the TMJ and the articular complex on sagittal Proton Density (PD) images in open and closed positions. In the closed mouth position, the posterior band of the articular disc is located within 10 degrees counterclockwise from a vertical reference line drawn through the...

Conclusion

The true-FISP sequence provides a unique evaluation of the dynamic movement of the TMJ disc-condyle complex and is a useful adjunct for the assessment of articular disc pathologies of the TMJ.

Personal information

Dr Igor Fomin Gold Coast University Hospital 1 Hospital Boulevard, Southport, QLD, 4215 [email protected]

References

Shimazaki Y, Saito K, Matsukawa S, Onizawa R, Kotake F, Nishio R et al. Image Quality Using Dynamic MR Imaging of the Temporomandibular Joint with True-FISP Sequence. Magnetic Resonance in Medical Sciences. 2007;6(1):15-20. Bakke M, Møller E, Werdelin L, Dalager T, Kitai N, Kreiborg S. Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2005;100(6):693-700. Krohn S, Gersdorff N, Wassmann T, Merboldt K,...