Cine-MRT des kiefergelenks im vergleich zur konventionellen MRT und achsiographie

Purpose: To evaluate Cine MRI (cMRI) of the temporomandibular joint in comparison to static MRI (sMRI) and axiography. Materials and Methods: In a prospective study with 57 healthy volunteers as well as 33 patients after temporomandibular joint (TMJ) surgery or with severe joint dysfunction, we measured the mobility of both condyle and disc as well as the sagittal angle of condylar inclination with sMRI and cMRI. Measurements and image analysis were performed by a radiologist and a maxillofacial surgeon in consensus. The results of axiography served as standard of reference. Result: Concerning the assessment of the discoligamentous complex, sMRI was superior to cMRI in the patient-group (sensitivity sMRI 85%, cMRI 76%), while no significant difference was found in the volunteer-group (sensitivity sMRI 97.4%, cMRI 98.3%). The results of cMRI and sMRI showed a highly significant correlation with each other, as well as with the axiographic reference tracings (r = 0.90). The average mobility of the disc and condyle was 6% and 10% higher in sMRI compared to cMRI (p = 0.001) and showed a slightly higher variance (0.043 vs. 0.038). Concerning the condylar inclination angle, both MRI-procedures had the best correlation (r = 0.94) with each other and axiography. Conclusion: Real-time MRI of the TMJ is comparable to axiography in its accuracy and is a useful adjunct to conventional static MRI.