Comparison of the effectiveness of high resolution ultrasound with MRI in patients with temporomandibular joint dısorders

Abstract

Objectives: To assess the effectiveness of a high resolution ultrasound for temporomandibular joint (TMJ) evaluation in comparison to MRI in patients with TMJ disorders. Methods: Our study comprised 50 patients (35 female and 15 male) with a mean age of 30.61. Clinical examination was performed. Bilateral imaging of TMJ was conducted by using a high-resolution ultrasound and 1.5 Tesla MR. Diagnostic accuracy of ultrasound was assessed for disc displacement and joint effusion in comparison to MRI. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy (Ac) were calculated for ultrasound. Measurements were compared by Bland & Altman and intraclass correlation coefficient (ICC). Significance level was set at p < 0.05. Results: Most frequent complaints were noise 42 (84%) and 34 (68%) pain. For disc position assessment with ultrasound for both sides and closed-open mouth, sensitivity, specificity, PPV, NPV and accuracy ranged between, 0.88 – 1, 0.60 – 0.87, 0.70 – 0.97, 0.75 – 1, and 0.84 – 0.98, respectively. For the diagnosis of effusion with ultrasound for both sides, sensitivity, specificity, PPV, NPV and accuracy ranged between 0.65 – 0.81, 0.91 – 1, 0.96 – 1, 0.45 – 0.46 and 0.72 – 0.84, respectively. ICC values calculated for intraobserver agreement for right and left TMJ for all measurements were found to be statistically significant (p < 0.001). ICC values ranged between 0.964 and 0.995 suggesting excellent correlation among ultrasound and MRI. In general, for ultrasound measurements we found a mean difference ranging between −0.182 and +0.130 mm in comparison to MRI. Conclusion: Ultrasound can be suggested as an adjunct to common imaging modalities in the assessment of TMJ.

Hand-Carried Ultrasonography Instrumentation in the Diagnosis of Temporomandibular Joint Dysfunction

“…Due to high Se, Spe, Ac, PPV, and NPV found for the assessment of anterior disc position and effusion along with highly accurate measurements, ultrasound can be suggested as an adjunct to common imaging modalities in the assessment of TMJ for oral and maxillofacial radiologists due to its advantages such as the following: non-ionizing radiation, availability, ease of usage, and providing real-time rapid images at a low cost [ 23 ].…”

Influence of Ultrasound Examination on Diagnosis and Treatment of Temporomandibular Disorders

“…In general, overview changes observed in this study included effusions, different stages of articular surface destruction, posterior disc ligament fibre damage, articular disc deformation and displacement. Numerous authors emphasize [ 9 , 14 , 17 , 19 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ] that ultrasound examination is extremely accurate in determining the direction of the intra-articular disc displacement or it can rule it out. Furthermore, it provides valuable information for planning for an occlusal splint and choosing supportive treatment.…”

Assessment of anterior positioning splint in conjunction with lateral pterygoid BTX injection to treat TMJ disc displacement with reduction — a preliminary report

“…Definitive diagnosis used MRIs to locate the anteriorly displaced articular disc in the closed mouth position and disc reduction in the open mouth position. Although other reports have introduced other imaging modalities (radiographs and ultrasound), the accuracy of ADD diagnosis with MRI has been superior [ 14 , 15 ] and it remains the most accurate especially in diagnosing anterior disc displacement with reduction. MR assessment is one of the main methods to visualize and assess disc status and position [ 14 ].…”