Department of Radiology, University of Brescia, Brescia, Italy.
Dentomaxillofac Radiol. 2021 May 1;50(4):20200232. doi: 10.1259/dmfr.20200232. Epub 2020 Dec 3.
To test real-time MRI (rtMRI) using HASTE sequences in patients with suspected internal disk derangement (IDD) of temporomandibular joint (TMJ) and to compare these sequences with standard static sequences.
99 TMJ were studied with both standard sequences (fat-saturated proton density) and HASTE sequences with high temporal resolution. Image quality was assessed using a 4-point Likert scale. Two radiologists analysed both standard and rtMRI sequences separately, randomly and blinded (by a third operator) to patients' names in order to assess inter-observer repeatability. One of the radiologists performed the analysis twice for assessing intra-observer repeatability. The same radiologists evaluated randomly and blinded to the previous assessment both the sequences and decided in consensus which was the most credible. Qualitative scores were compared using Friedman's test while concordance between radiologists and sequences was evaluated using the concordance correlation coefficient.
At image quality analysis, mean score was 3.41 for static MRI and 3.82 for rtMRI, with a statistically significant difference in favour of rtMRI ( < 0.0001). Inter-rater concordance between operator 1 (Op1) and operator 2 (Op2) with regard to the same sequence was high for both static and rtMRI sequences (0.824 and 0.888, respectively). Inter-rater variability of Op1 and Op2 between static and rtMRI sequences was lower (0.647 for Op1 and 0.633 for Op2). Among 71 discordances between sequences, 60 were judged in favour of rtMRI, while 11 were in favour of static MRI.
rtMRI with HASTE sequences is a robust technique and provide additional information in assessing IDD compared to static sequences.
在疑似颞下颌关节（TMJ）内部盘紊乱（IDD）的患者中使用 HASTE 序列进行实时 MRI（rtMRI）检测，并将这些序列与标准静态序列进行比较。
对 99 个 TMJ 同时进行了标准序列（脂肪饱和质子密度）和具有高时间分辨率的 HASTE 序列检查。使用 4 分李克特量表评估图像质量。两名放射科医生分别独立、随机且盲法（由第三名操作员）对患者姓名进行标准和 rtMRI 序列分析，以评估观察者间的可重复性。其中一名放射科医生对观察者内的可重复性进行了两次分析。同一名放射科医生对随机且盲法（不了解之前评估结果）的序列进行评估，并在共识的基础上决定哪个序列最可信。使用 Friedman 检验比较定性评分，同时使用一致性相关系数评估放射科医生和序列之间的一致性。
在图像质量分析中，静态 MRI 的平均得分为 3.41，rtMRI 的平均得分为 3.82，rtMRI 的得分具有统计学显著优势（<0.0001）。同一序列中，放射科医生 1（Op1）和放射科医生 2（Op2）之间的组内一致性很高，分别为 0.824 和 0.888。Op1 和 Op2 之间静态和 rtMRI 序列的组间变异性较低（Op1 为 0.647，Op2 为 0.633）。在 71 次序列不一致中，有 60 次判断有利于 rtMRI，而有 11 次判断有利于静态 MRI。
与静态序列相比，HASTE 序列的 rtMRI 是一种强大的技术，可以提供额外的 IDD 评估信息。
