Real-Time Magnetic Resonance Imaging of Temporomandibular Joint Dynamics

ABSTRACT

This study evaluated the use of a novel real-time MRI technique based on fast low angle shot (FLASH) MRI with radial encoding, gridding reconstruction, and sliding window for the assessment of temporomandibular joint (TMJ) dynamics in a cohort of 30 young volunteers without prior diagnosis of TMJ pathology. High-resolution images (0.75 mm2 0.75 mm2, 5 mm section thickness) were obtained at 3 frames per second for active jaw movements without adjunctive devices. Real-time movies were evaluated with respect to image artefacts, anatomical visibility, diagnostic confidence, and TMJ function. During the entire opening and closing of the mouth, the relative positions of the mandibular condyle and articular disc were well depicted. Mean scores were 1.01 ± 0.65 for motion artefacts (scale: 0 = no to 3 = severe artefacts) and 2.03 ± 0.71 for anatomical detectability (scale: 1 = excellent to 5 = not visible). High inter-observer agreements were found for assessments of mandibular condyle movements (k = 0.83) and articular disc displacements (k = 0.91). In latter cases, the point of disc reduction could precisely be identified. In conclusion, the proposed real-time MRI method offers robust access to TMJ dynamics with good image quality.