The value of magnetic resonance arthrography of the temporomandibular joint in imaging disc adhesions and perforations.
OBJECTIVE
This study attempted to validate MR arthrography (MRAr) of the temporomandibular joint (TMJ) in detecting the position, integrity and relations of the articular disc and retrodiscal tissue.


METHODS
A total of 20 TMJs from 10 patients with severe TMJ dysfunction underwent MRI and MRAr. A paramagnetic contrast medium was injected into the upper joint compartment to observe possible adhesions and/or leakage into the lower compartment. 15 TMJs were surgically or arthroscopically explored and restored.


RESULTS
MRAr was approximately in the same diagnostic value as MRI when locating position, but superior in detecting disc perforations (eight TMJs) and adhesions (seven TMJs) appearing together in four cases. Surgery confirmed radiological findings in all but one case, where arthroscopy and surgery failed to confirm a disc perforation indicated by MRAr.


CONCLUSIONS
TMJ MRAr may simultaneously reveal adhesions and perforations. Sensitivity and the probability of false-positive results require further study.
University Clinic of Oral and Maxillofacial Surgery, Thessaloniki, Greece. gvenetis@dent.auth.gr
G
G
Venetis
M
M
Pilavaki
K
K
Triantafyllidou
A
A
Papachristodoulou
N
N
Lazaridis
P
P
Palladas
D000328:Adult; D000368:Aged; D001175:Arthrography; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
Int J Oral Maxillofac Surg. 2004 Jun;33(4):344-8
15145035
Int J Oral Maxillofac Surg. 2001 Apr;30(2):118-22
11405446
Radiology. 1992 Jan;182(1):280-2
1727298
Int J Oral Maxillofac Surg. 2002 Jun;31(3):252-6
12190129
Skeletal Radiol. 2008 Jan;37(1):9-18
17530246
J Oral Maxillofac Surg. 2005 Aug;63(8):1155-61
16094584
Dentomaxillofac Radiol. 2007 Dec;36(8):472-7
18033943
BMJ. 1998 Jul 18;317(7152):190-4
9665905
J Oral Maxillofac Surg. 2000 Sep;58(9):978-83; discussion 984
10981977
J Am Dent Assoc. 2002 Apr;133(4):442-51
11991461
Radiology. 1987 Jul;164(1):65-70
3588928
J Oral Maxillofac Surg. 2005 Apr;63(4):471-8
15789318
Br J Oral Maxillofac Surg. 2002 Jun;40(3):220-8
12054713
J Am Dent Assoc. 1990 Mar;120(3):283-90
2179357
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Sep;106(3):419-25
18504154
AJR Am J Roentgenol. 1990 Jul;155(1):105-7
2112829
J Oral Rehabil. 2007 Apr;34(4):237-45
17371560
Int J Oral Maxillofac Surg. 2005 Oct;34(7):733-8
15979852
J Craniomandib Disord. 1992 Fall;6(4):301-55
1298767