MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference

Abstract

Objective

To determine the best suited sagittal MRI sequence out of a standard temporo-mandibular joint (TMJ) imaging protocol for the assessment of the cortical bone of the mandibular condyles of cadaveric specimens using micro-CT as the standard of reference.

Methods

Sixteen TMJs in 8 human cadaveric heads (mean age, 81 years) were examined by MRI. Upon all sagittal sequences, two observers measured the cortical bone thickness (CBT) of the anterior, superior and posterior portions of the mandibular condyles (i.e. objective analysis), and assessed for the presence of cortical bone thinning, erosions or surface irregularities as well as subcortical bone cysts and anterior osteophytes (i.e. subjective analysis). Micro-CT of the condyles was performed to serve as the standard of reference for statistical analysis.

Results

Inter-observer agreements for objective (r = 0.83-0.99, P < 0.01) and subjective (κ = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR).

Conclusion

The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence.

Key Points

MRI may be used to assess the cortical bone of the TMJ.

Depiction of cortical bone is best on 3D FSPGR sequences.

MRI can assess treatment response in patients with TMJ abnormalities.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. 1.

    Magnusson T, Egermark I, Carlsson GE (2000) A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. J Orofac Pain 14:310–319

    PubMed  CAS  Google Scholar 

  2. 2.

    Moen K, Hellem S, Geitung JT, Skartveit L (2010) A practical approach to interpretation of MRI of the temporomandibular joint. Acta Radiol 51:1021–1027

    PubMed  Article  Google Scholar 

  3. 3.

    Cannizzaro E, Schroeder S, Muller LM, Kellenberger CJ, Saurenmann RK (2011) Temporomandibular joint involvement in children with juvenile idiopathic arthritis. J Rheumatol 38:510–515

    PubMed  Article  Google Scholar 

  4. 4.

    Abramowicz S, Cheon JE, Kim S, Bacic J, Lee EY (2011) Magnetic resonance imaging of temporomandibular joints in children with arthritis. J Oral Maxillofac Surg 69:2321–2328

    PubMed  Article  Google Scholar 

  5. 5.

    Müller L, Kellenberger CJ, Cannizzaro E et al (2009) Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology (Oxford) 48:680–685

    Article  Google Scholar 

  6. 6.

    Lewis EL, Dolwick MF, Abramowicz S, Reeder SL (2008) Contemporary imaging of the temporomandibular joint. Dent Clin North Am 52:875–890

    PubMed  Article  Google Scholar 

  7. 7.

    Boyesen P, Haavardsholm EA, van der Heijde D et al (2011) Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients. Ann Rheum Dis 70:176–179

    PubMed  Article  Google Scholar 

  8. 8.

    Lee EY, Sundel RP, Kim S, Zurakowski D, Kleinman PK (2008) MRI findings of juvenile psoriatic arthritis. Skeletal Radiol 37:987–996

    PubMed  Article  Google Scholar 

  9. 9.

    McGibbon CA, Bencardino J, Yeh ED, Palmer WE (2003) Accuracy of cartilage and subchondral bone spatial thickness distribution from MRI. J Magn Reson Imaging 17:703–715

    PubMed  Article  Google Scholar 

  10. 10.

    Reichert IL, Benjamin M, Gatehouse PD et al (2004) Magnetic resonance imaging of periosteum with ultrashort TE pulse sequences. J Magn Reson Imaging 19:99–107

    PubMed  Article  Google Scholar 

  11. 11.

    Phan CM, Matsuura M, Bauer JS et al (2006) Trabecular bone structure of the calcaneus: comparison of MR imaging at 3.0 and 1.5 T with micro-CT as the standard of reference. Radiology 239:488–496

    PubMed  Article  Google Scholar 

  12. 12.

    McGibbon CA, Dupuy DE, Palmer WE, Krebs DE (1998) Cartilage and subchondral bone thickness distribution with MR imaging. Acad Radiol 5:20–25

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    European Union (2002) Additional protocol to the convention on human rights and biomedicine, on transplantation of organs and tissues of human origin. ETS 186, Article 16–18

  14. 14.

    Swiss Academy of Medical Science (2008) Verwendung von Leichen und Leichenteilen in der medizinischen Forschung sowie Aus-, Weiter- und Fortbildung. Medical–Ethical Guidelines and Recommendations, pp 1–11

  15. 15.

    Tasali N, Cubuk R, Aricak M et al (2011) Temporomandibular joint (TMJ) pain revisited with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Eur J Radiol. doi:10.1016/j.ejrad.2011.01.044

  16. 16.

    McGibbon CA (2003) Inter-rater and intra-rater reliability of subchondral bone and cartilage thickness measurement from MRI. Magn Reson Imaging 21:707–714

    PubMed  Article  Google Scholar 

  17. 17.

    McGibbon CA, Bencardino J, Palmer WE (2003) Subchondral bone and cartilage thickness from MRI: effects of chemical-shift artifact. MAGMA 16:1–9

    PubMed  Article  Google Scholar 

  18. 18.

    Peh WC, Chan JH (2001) Artifacts in musculoskeletal magnetic resonance imaging: identification and correction. Skeletal Radiol 30:179–191

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Zand KR, Reinhold C, Haider MA, Nakai A, Rohoman L, Maheshwari S (2007) Artifacts and pitfalls in MR imaging of the pelvis. J Magn Reson Imaging 26:480–497

    PubMed  Article  Google Scholar 

  20. 20.

    Louis O, Cattrysse E, Scafoglieri A, Luypaert R, Clarys JP, de Mey J (2010) Accuracy of peripheral quantitative computed tomography and magnetic resonance imaging in assessing cortical bone cross-sectional area: a cadaver study. J Comput Assist Tomogr 34:469–472

    PubMed  Article  Google Scholar 

  21. 21.

    Issever AS, Link TM, Newitt D, Munoz T, Majumdar S (2010) Interrelationships between 3-T-MRI-derived cortical and trabecular bone structure parameters and quantitative-computed-tomography-derived bone mineral density. Magn Reson Imaging 28:1299–1305

    PubMed  Article  Google Scholar 

  22. 22.

    Stehling C, Vieth V, Bachmann R et al (2007) High-resolution magnetic resonance imaging of the temporomandibular joint: image quality at 1.5 and 3.0 Tesla in volunteers. Invest Radiol 42:428–434

    PubMed  Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank L. Völlmer, M. Studhalter, B. Werner and A. Jezler for their technical and logistical assistance.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Christoph A. Karlo.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Karlo, C.A., Patcas, R., Kau, T. et al. MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference. Eur Radiol 22, 1579–1585 (2012). https://doi.org/10.1007/s00330-012-2391-8

Download citation

Keywords

  • Mandibular condyle
  • MRI
  • Micro-CT
  • TMJ
  • JIA