CT-like MRI using the zero-TE technique for osseous changes of the TMJ

Abstract

Objective: This study was conducted to assess the clinical usability of the zero-echo time (ZTE) technique of MRI for evaluating bone changes of the temporomandibular joint (TMJ) in comparison with CBCT. Methods: Twenty patients with TMJ disorder who underwent both CBCT and MRI were randomly selected. CBCT images were obtained with an Alphard 3030 device (Asahi Roentgen Ind., Co. Ltd, Kyoto, Japan). MRIs were obtained using a 3.0 T scanner (Pioneer; GE Healthcare, Waukesha, WI, USA) and a 21-channel head coil. An isotropic three-dimensional proton-density-weighted ZTE sequence was acquired. Two radiologists evaluated 40 joints of 20 patients for the presence of the following osseous changes: flattening, erosion, osteophyte and sclerosis of the condyle; and flattening, erosion and sclerosis of the articular fossa. CBCT and ZTE-MRI assessments were performed at a 2-month interval. The prevalence-adjusted and bias-adjusted κ statistic was used to analyse interexaminer and intraexaminer agreement and the agreement between ZTE-MRI and CBCT. Results: Intraexaminer and interexaminer agreement analyses of ZTE-MRI showed high reproducibility (κ>0.80), which was comparable to that of CBCT. Flattening, osteophyte and sclerosis of the condyle and all types of bone changes in the mandibular fossa showed nearly perfect agreement between CBCT and ZTE-MRI (κ = 0.80–0.90). Erosion of the condyle showed substantial agreement between both sets of images (κ = 0.65–0.70). Conclusions: It is suggested that ZTE-MRI provides clinically reliable images for bone assessment in TMJ disorder. MRI may become a beneficial diagnostic tool for patients with both TMJ disc and bone pathology, with advantages involving medical costs and radiation dose.

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

“…MRI is currently considered the gold standard in the diagnosis of morphology and position of the temporomandibular joint disc [27,28]. Moreover, recent research by Lee et al [29] stated that zero-echo time (ZTE) technique of MRI might be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. The authors used a 3.0 T scanner with a 21-channel head coil.…”

Analysis of three-dimensional imaging findings and clinical symptoms in patients with temporomandibular joint disorders

“…MRI is known to be useful for evaluating discs and soft tissues (7). Conventional MRI has limitations in obtaining optimal bone images, and a study using the zero-TE sequence to compensate for these limitations have been reported (8). MRI is absolutely contraindicated in patients with ferromagnetic vascular clips and pacemakers, and imaging may be difficult if the patient experiences claustrophobia, which occurs in 1-15% of patients undergoing MRI (9).…”

MRI of Temporomandibular Joint Disorders: Recent Advances and Future Directions

“…More important, quantitative and functional evaluation of multiple biochemical properties of TMJ structures has become feasible, and has been preliminarily investigated by applying various MRI sequences and sophisticated postprocessing algorithms, 15–17 thereby providing a better understanding of TMJ structures and a better comprehension of its disorders. Moreover, using the novel technique of zero echo time (ZTE), the comparable diagnostic value of osseous abnormalities in TMJ has also been achieved in MRI 18 …”