DYNAMIC FUNCTIONAL MAGNETIC RESONANCE IMAGING OF TEMPOROMANDIBALAR JOINT

Abstract

The aim of the study was to compare the potential of fast pulse sequences and traditional static images for evaluation of temporomandibular joint (TMJ) biomechanics and to optimize the magnetic resonance imaging (MRI) protocol of TMJ by inclusion of dynamic scanning to improve the diagnosis of internal derangements.

Material and methods. Dynamic MRI with HASTE and true-FISP pulse sequences was integrated into conventional MRI examination of TMJ in 16 symptomatic patients with pain, restricted motion and clicking in the joint. MRI was performed on superconductive 1.5 T scanner Magnetom Espree (Siemens, Germany). The presence of motion and susceptibility artifacts, range of mandible head motion and intrarticular disc location in different jaw positions were analyzed when comparing static and dynamic series.

Results and discussion. HASTE was chosen for dynamic functional MRI of TMJ because it was less prone to susceptibility artifacts and provided better tissue contrast compared to true-FISP. Our initial experience has demonstrated dynamic scanning to be a time-efficient supplementary technique providing detailed information about TMJ biomechanics during active jaw movements at a high temporal resolution compared to traditional MRI examination. However, minimal anterior disc dislocation could be missed on dynamic series due to poor visualization of the posterior disc band on full closing. The further optimization of dynamic scanning technique on a large patients group using principles of the evidence-based medicine is needed. This would allow improving the diagnosis and assisting clinicians to optimize treatment strategy in a wide range of TMJ disorders.