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.
Dentomaxillofac Radiol. 2010 Dec;39(8):475-85. doi: 10.1259/dmfr/29741224.
This study describes an improved method for examining and diagnosing temporomandibular joint (TMJ) dynamics by 3.0 T pseudodynamic MRI.
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.
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).
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.
本研究通过 3.0T 拟动力 MRI 描述了一种检查和诊断颞下颌关节（TMJ）动力学的改良方法。
对志愿者（1 名无 TMJ 关节炎和 8 名有 TMJ 关节炎）进行临床观察和常规静态 MRI 检查，然后在从闭口到张口完全打开的位置进行 3.0T 拟动力 MRI。在矢状图像上对髁突头（Cd）、关节盘前边界（Da）和关节盘后边界（Dp）进行数字化，以确定轨迹和速度模式。
根据 TMJ 是否存在功能障碍，患者分为三组：组 1，TMJ 右侧或左侧无功能障碍；组 2，TMJ 右侧或左侧功能障碍；组 3，TMJ 双侧功能障碍。在 75%的患者（16 个关节中的 12 个）中，拟动力 TMJ 分析有助于确定功能异常。使用基于三种轨迹和七种速度模式的评分系统，粘连和穿孔的关节盘得分明显低于前移位（有或无复位）和无异常的关节盘（P = 0.019<0.05）。
基于 3.0T 拟动力 MRI 的轨迹和速度模式可确定受累侧，并确定 Cd 以及 Da 和 Dp 的发病程度。可以识别具有前移位（有或无复位）的关节盘的典型异常运动模式和关节盘的病理性结构变化（如粘连和穿孔）。
