DYNAMIC FUNCTIONAL MAGNETIC RESONANCE IMAGING OF TEMPOROMANDIBALAR JOINT
Alexandr Petrovich DERGILEV1, Pavel Gavrilovich SYSOLYATIN2, Anna Vladimirovna SUDARKINA3, Igor Anatoljevich PANIN2
1Novosibirsk State
Medical University of Minzdrav of Russia, State Novosibirsk Regional
Clinical Hospital, Novosibirsk Railway Clinical Hospital
a.dergilev@mail.ru
2Novosibirsk State Medical University of Minzdrav of Russia, State Novosibirsk Regional Clinical Hospital
sysolyatinpg@mail.ru
3Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk Railway Clinical Hospital
a.sudarkina@mail.ru
Keywords: височно-нижнечелюстной сустав, ВНЧС, магнитно-резонансная томография, МРТ, динамическая МРТ, кино-МРТ
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.
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