title: MRI-guided injection procedures of the temporomandibular joints in children and adults: technique, accuracy, and safety.
abstract: OBJECTIVE
  The purpose of our study was to test the hypothesis that real-time MRI-guided, selective injection procedures of the temporomandibular joints are feasible, accurate, and safe when performed on a clinical open-bore 1.5-T MR system.
  
  
  METHODS
  A retrospective analysis of 67 injection procedures of the temporomandibular joints (55% [37/67] were therapeutic injections, 27% [18/67] were diagnostic injections, and 18% [12/67] were arthrocentesis procedures), performed in 31 patients (58% [18/31] female, 42% [13/31] male; mean age, 14 years; age range, 3-34 years), was made. Seven of 38 (18%) subjects had two temporally separate procedures. Determinations of skin entry points, puncture, and injection were performed under real-time MRI. Data were assessed for rate of successful injections, quantitative and qualitative image quality, time requirements, and occurrence of complications.
  
  
  RESULTS
  Drug delivery was successful in all procedures. The quality of real-time FLASH 2D MR images was sufficient in all cases. Real-time MRI proved to be helpful to achieve high rates of intraarticular injections. Contrast-to-noise ratios were sufficiently high for good delineation of relevant structures. Average length of time was 25 minutes (range, 16-53 minutes). No major complications occurred.
  
  
  CONCLUSIONS
  We accept the hypothesis that real-time MRI-guided selective injection procedures of the temporomandibular joints are feasible, accurate, and safe when performed on a clinical open-bore 1.5-T MR system.
authors.affiliation: Department of Diagnostic Radiology, Eberhard-Karls-University Tübingen, Tübingen, Germany. jan.fritz@gmx.net
authors.forename: Jan
authors.initials: J
authors.lastname: Fritz
authors.forename: Christoph
authors.initials: C
authors.lastname: Thomas
authors.forename: Nikolay
authors.initials: N
authors.lastname: Tzaribachev
authors.forename: Marius S
authors.initials: MS
authors.lastname: Horger
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Lewin
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003199:Computer Systems; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000009:adverse effects* / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000379:methods*; D008297:Male; D015642:Radiology, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013704:Temporomandibular Joint / Q000033:anatomy & histology* / Q000187:drug effects*; D055815:Young Adult