Bristela Margit, Skolka Astrid, Eder Jaryna, Szomolanyi Pavol, Weber Michael, Piehslinger Eva, Schmid-Schwap Martina, Trattnig Siegfried
University Clinic of Dentistry, Department of Prosthodontics, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria.
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria; Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Dubravska cesta 9, 84104 Bratislava, Slovakia.
Magn Reson Imaging. 2019 May;58:125-134. doi: 10.1016/j.mri.2019.02.002. Epub 2019 Feb 10.
INTRODUCTION: T2 mapping, as a quantitative biochemical MRI-technique that provides information on water and collagen fiber content and composition, was shown to be clinically feasible for the evaluation of healthy temporomandibular joints. OBJECTIVES: The aim of our study was to compare the T2 values of whole discs in patients with and without disc dislocation, to evaluate the possible influence of morphological findings on T2 values and to assess the interrater agreement. METHODS: Sixty-six patients were included in the study. Three experienced examiners assessed the perceptibility of the morphological parameters and the position of the articular disc on the morphological MR images. On the T2 maps, the T2 values of the region-of-interest (ROI) were assessed. RESULTS: The ICC (Intraclass Correlation Coefficient) for the reproducibility of the T2 values was 0.717. The assessment of the morphologic parameters was excellent or good in most of the discs. There was no significant difference in the T2 values based on disc position or signal intensity. But, a statistically significant moderation effect (p = .014) could be identified, indicating that the effect of disc position differs for different signal intensities. Condyle position, effusion, and degenerative changes showed pronounced moderation effects on the T2 values. CONCLUSION: Due to the high sensitivity to effusion, T2 mapping currently seems to be unsuitable as a diagnostic tool for routine use in the temporomandibular joint. The moderation effect clearly shows the influence of factors such as signal intensity, effusion, arthrosis, and condyle position. Perhaps a solution for these problems could be the development of dedicated TMJ coils for higher field strengths at 7.0 T.
引言:T2 映射作为一种定量生化磁共振成像技术,可提供有关水和胶原纤维含量及组成的信息,已被证明在评估健康颞下颌关节方面具有临床可行性。 目的:我们研究的目的是比较有无盘状移位患者整个关节盘的 T2 值,评估形态学表现对 T2 值的可能影响,并评估评分者间的一致性。 方法:66 名患者纳入本研究。三名经验丰富的检查者评估形态学参数的可感知性以及形态学磁共振图像上关节盘的位置。在 T2 图上,评估感兴趣区域(ROI)的 T2 值。 结果:T2 值重复性的组内相关系数(ICC)为 0.717。大多数关节盘的形态学参数评估为优或良。基于关节盘位置或信号强度的 T2 值无显著差异。但是,可以识别出具有统计学意义的调节效应(p = 0.014),表明关节盘位置的效应因信号强度不同而有所差异。髁突位置、积液和退行性改变对 T2 值显示出明显的调节效应。 结论:由于对积液高度敏感,T2 映射目前似乎不适合作为颞下颌关节常规使用的诊断工具。调节效应清楚地显示了信号强度、积液、关节病和髁突位置等因素的影响。或许解决这些问题的一个办法是开发适用于 7.0 T 更高场强的专用颞下颌关节线圈。
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