Zhou Xi, Wang Yiping, Bai Xiuxiu, Xia Jun, Liang Xueyun, Wang Xiaomei, Xia Zhiqing, Zhang Jianjian, Yu Jiashen, Shen Guoqiang, Zhang Li, Long Jia, Chen Jiakuan, Zhu Yaomin, Le Hongbo
Department of Radiology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China.
Oral and maxillofacial surgery, Shenzhen Stomatological Hospital, Shenzhen University, Shenzhen, China.
Eur Radiol. 2025 Jul 11. doi: 10.1007/s00330-025-11795-8.
The study aimed to quantitatively assess the signal changes in the lateral pterygoid muscle (LPM) of patients with acute and chronic temporomandibular joint disorders (TMD) using T1 mapping and T2 mapping techniques, and to explore the correlation between these changes and clinical symptoms.
Fifty-five acute TMD patients, 121 chronic TMD patients, and 19 normal controls (NC) were enrolled in this prospective study. T1 mapping and T2 mapping sequences were acquired to obtain T1 and T2 values of the superior heads of the lateral pterygoid muscle (SHLP) and inferior heads of the lateral pterygoid muscle (IHLP). According to the position of the TMD, acute and chronic TMD patients were further divided into two subgroups, which were the normal position group (TMD-NP) and the anterior disc displacement group (TMD-ADD).
Chronic TMD patients exhibited significantly lower T1 mapping values in both SHLP and IHLP compared to NC and acute TMD patients (p < 0.05). Conversely, acute TMD-ADD patients showed significantly higher T2 mapping values in SHLP and IHLP compared to acute TMD-NP and NC (p < 0.05). Positive correlation was observed between T2 mapping values and numerical rating scale (NRS) scores for pain in both acute and chronic TMD patients (p < 0.05).
Chronic TMD may be associated with fat infiltration in the LPM, while acute TMD-ADD may present with inflammatory edema. The strong correlation between T2 mapping values and pain scores underscores the clinical utility of these techniques in assessing TMD severity and monitoring treatment responses.
Question Are there differences in T1 and T2 mapping signals of the LPMs between patients with acute and chronic TMD? Findings Chronic TMD patients had lower T1 mapping values, and cut TMD-ADD patients had higher T2 mapping values than acute TMD-NP and NC. Clinical relevance By providing quantitative measures of muscle signal changes, T1 mapping and T2 mapping may help clinicians differentiate between acute and chronic TMD, assess the severity of muscle involvement, and guide treatment decisions.
本研究旨在使用T1映射和T2映射技术定量评估急性和慢性颞下颌关节紊乱病（TMD）患者翼外肌（LPM）的信号变化，并探讨这些变化与临床症状之间的相关性。
本前瞻性研究纳入了55例急性TMD患者、121例慢性TMD患者和19例正常对照（NC）。采集T1映射和T2映射序列，以获取翼外肌上头（SHLP）和翼外肌下头（IHLP）的T1和T2值。根据TMD的位置，急性和慢性TMD患者进一步分为两个亚组，即正常位置组（TMD-NP）和关节盘前移位组（TMD-ADD）。
与NC和急性TMD患者相比，慢性TMD患者的SHLP和IHLP的T1映射值均显著降低（p<0.05）。相反，与急性TMD-NP和NC相比，急性TMD-ADD患者的SHLP和IHLP的T2映射值显著更高（p<0.05）。在急性和慢性TMD患者中，均观察到T2映射值与疼痛数字评定量表（NRS）评分之间存在正相关（p<0.05）。
慢性TMD可能与LPM中的脂肪浸润有关，而急性TMD-ADD可能表现为炎症性水肿。T2映射值与疼痛评分之间的强相关性强调了这些技术在评估TMD严重程度和监测治疗反应方面的临床实用性。
问题：急性和慢性TMD患者LPM的T1和T2映射信号是否存在差异？研究结果：慢性TMD患者的T1映射值较低，而急性TMD-ADD患者的T2映射值高于急性TMD-NP和NC。临床意义：通过提供肌肉信号变化的定量测量，T1映射和T2映射可能有助于临床医生区分急性和慢性TMD，评估肌肉受累的严重程度，并指导治疗决策。
