Comparing proton density and turbo spin echo T2 weighted static sequences with dynamic half-Fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study.
OBJECTIVE
The aim of this prospective study was to compare dynamic and static sequences in the evaluation of temporomandibular joint disorders using a 3.0 -T imaging unit.


METHODS
194 patients were evaluated by static (double echo proton density weighted/turbo spin echo T2 weighted sequences) and dynamic (half-Fourier single-shot turbo spin echo sequences)imaging. Two radiologists evaluated in consensus the quality of images, the disc position and morphological alterations. The Kendall rank correlation coefficient (τ-b) was used to compare the qualitative rating between static and dynamic sequences. Cohen's kappa coefficient (k) was used to assess the agreement of disc position and morphological alterations between both sequences. The intraclass correlation coefficient was used to calculate the intraobserver variability. The significance was set at p ≤ 0.05.


RESULTS
The correlation between both sequences in the qualitative evaluation was τ-b = 0.632. The agreement between both techniques in the evaluation of disc position was k = 0.856. The agreement between both techniques in assessing the morphological alterations was k = 0.487. In the static sequences, the intraclass correlation coefficient was 0.915 in the qualitative evaluation, 0.873 in the evaluation of disc position and 0.934 in the assessment of morphological alterations. In the dynamic sequences, the intraclass correlation coefficient was 0.785 in the qualitative evaluation, 0.935 in the evaluation of disc position and 0.826 in the assessment of morphological alterations.


CONCLUSIONS
Static imaging remains the gold standard in the evaluation of the temporomandibular joint. Dynamic imaging is a valuable tool that can provide additional information about topographic changes in the disc-condyle relationship.
Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy;
M
M
Cassetta
F
F
Barchetti
N
N
Pranno
M
M
Marini
D016477:Artifacts; D005355:Fibrosis; D005583:Fourier Analysis; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D004204:Joint Dislocations / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008335:Mandibular Condyle / Q000473:pathology; D010003:Osteoarthritis / Q000175:diagnosis; D011446:Prospective Studies; D011522:Protons; D011626:Pterygoid Muscles / Q000473:pathology; D016059:Range of Motion, Articular / Q000502:physiology; D013582:Synovial Fluid; D013701:Temporal Bone / Q000473:pathology; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*
D011522:Protons
image interpretation, computer-assisted; magnetic resonance imaging; temporomandibular joint; temporomandibular joint disorders