Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ--a pilot study.
The aim of this study was to compare sensitivity, specificity, accuracy and positive and negative predictive value for high-resolution ultrasonography (HR-US) in diagnosing degenerative changes, effusion and disk displacement using magnetic resonance imaging (MRI) as a reference. Over a period of 6 months, 100 patients with TMJ disorders (200 TMJs) were investigated by an experienced radiologist with HR-US and magnetic resonance imaging (MRI). The MRI investigation showed degenerative changes in 190 joints (95%), while an effusion was found in 59 (29.5%) joints. At closed-mouth position a disc dislocation was found in 138 joints (69%) and in maximum-mouth-opening position disc dislocation was diagnosed in 76 joints (38%). In the determination of degenerative changes HR-US showed a sensitivity of 94%, a specificity of 100% and an accuracy of 94%. In the detection of effusion HR-US yielded a sensitivity of 81%, a specificity of 100% and an accuracy of 95%. In the determination of disk displacement at closed-mouth position HR-US showed a sensitivity, specificity and an accuracy of 92% each. At maximum-mouth-opening position HR-US reached a sensitivity of 86%, a specificity of 91% and an accuracy of 90%. The results of the current study imply that HR-US is a valuable diagnostic imaging method of the TMJ which can be used as an alternative method to a MRI-investigation, but is yet not able to replace it. Further studies have to be done to reduce false-negative results.
Jank
S
S
Department of Oral and Maxillofacial Surgery, University of Innsbruck, Maximilianstr. 10, A-6020 Innsbruck, Austria. siegfried.jank@gmx.de
Emshoff
R
R
Norer
B
B
Missmann
M
M
Nicasi
A
A
Strobl
H
H
Gassner
R
R
Rudisch
A
A
Bodner
G
G
D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000000981:diagnostic imaging; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*; D014463:Ultrasonography