Temporomandibular joint (TMJ) pain revisited with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)

Abstract Purpose We aimed to assess the contrast enhancement patterns of the retrodiscal tissue with dynamic contrast-enhanced MR imaging (DCE-MRI) with respect to different temporomandibular joint disc pathologies. Additionally, we questioned the relationship between the temporomandibular joint (TM...

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Bibliographic Details
Published in:European journal of radiology 2012-03, Vol.81 (3), p.603-608
Main Authors: Tasali, N, Cubuk, R, Aricak, M, Ozarar, M, Saydam, B, Nur, H, Tuncbilek, N
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
Arthralgia - diagnosis
Contrast Media
Dynamic contrast-enhanced
Female
Gadolinium DTPA
Humans
Magnetic Resonance Imaging - instrumentation
Magnetic Resonance Imaging - methods
Male
Pain
Pain Measurement
Quantitative analysis
Radiology
Temporomandibular joint
Temporomandibular Joint Disc - pathology
Temporomandibular Joint Disorders - diagnosis
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Summary:Abstract Purpose We aimed to assess the contrast enhancement patterns of the retrodiscal tissue with dynamic contrast-enhanced MR imaging (DCE-MRI) with respect to different temporomandibular joint disc pathologies. Additionally, we questioned the relationship between the temporomandibular joint (TMJ) pain and the contrast enhancement pattern of the retrodiscal tissue regardless of the TMJ disc position. Materials and methods 52 joints of 26 patients (4 males and 22 females) who have pain in at least at one of their TMJ were included in this study. For the qualitative analysis, the joints were divided into four groups in terms of their disc positions: normal (1), partially displaced with or without reduction (2), totally dislocated with reduction (3) and totally dislocated without reduction (4). Besides, two different joint groups were constituted, namely the painful group and painless group according to the clinical findings without taking the TMJ disc positions into account. Quantitative analyses were made by means of measuring signal intensity ratios (SI) ratio at the retrodiscal tissue (from internal side and external side of the each joint) using DCE-MRI and these measurements were analyzed with paired samples t test to define the difference between the measurements. At the second stage, the time-dependent arithmetical mean values of the SI ratios were calculated for each joint group and significant differences between the groups were questioned using analysis of variance (ANOVA) test. Besides, painful and painless groups which were classified on the basis of the clinical data were compared according to the mean SI ratios found for each joint and the significant differences between these two groups were assessed by means of Student's T test. The results were assessed in 95% confidence interval where the significance level was p < 0.05. Results A significant difference was observed between the internal and external contrast enhancement of the joints with partial displacement. Another significant difference was found between the average time versus SI ratio curves of the four groups. In consequence of the comparison made between the joints classified as painful and painless on the basis of the clinical data, one more significant difference was observed according to the mean SI ratios of the groups without taking the TMJ disc position into account. Conclusion The contrast enhancement patterns in the retrodiscal tissues of the painful joints showed signif
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2011.01.044