Abstract
The prevalence of temporomandibular joint disorder (TMD) is gradually increasing, and magnetic resonance imaging (MRI) is becoming increasingly common as a modality used to diagnose TMD. Edema and osteonecrosis in the bone marrow of the mandibular condyle have been considered to be precursors of osteoarthritis, but these changes are not evaluated accurately and quantitatively on routine MRI. The iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) method, as a cutting-edge MRI technique, can separate fat and water using three asymmetric echo times and the three-point Dixon method. The purpose of this study was to analyze the quantitative fat fraction (FF) in the mandibular condyle head using the IDEAL-IQ method. Seventy-nine people who underwent MRI using IDEAL-IQ were investigated and divided into 1) the control group, without TMD symptoms, and 2) the TMD group, with unilateral temporomandibular joint (TMJ) pain. In both groups, the FF of the condyle head in the TMJ was analyzed by two oral and maxillofacial radiologists. In the TMD group, 29 people underwent cone-beam computed tomography (CBCT) and the presence or absence of bony changes in the condylar head was evaluated. The FF measurements of the condyle head using IDEAL-IQ showed excellent inter-observer and intra-observer agreement. The average FF of the TMD group was significantly lower than that of the control group (p < 0.05). In the TMD group, the average FF values of joints with pain and joints with bony changes were significantly lower than those of joints without pain or bony changes, respectively (p < 0.05). The FF using IDEAL-IQ in the TMJ can be helpful for the quantitative diagnosis of TMD.
Highlights
Introductioncomputed tomography (CT) is an excellent imaging modality for evaluating bony changes of the temporomandibular joint (TMJ) and can be expressed by quantifying the density of tissue using Hounsfield units (HU), which are relatively set based on the value of -1000 for air and 0 for water
The prevalence of temporomandibular joint disorder (TMD) is gradually increasing, and conebeam computed tomography (CBCT), computed tomography (CT) and magnetic resonance imaging (MRI) are becoming increasingly common as modalities used to diagnose TMD.CT is an excellent imaging modality for evaluating bony changes of the temporomandibular joint (TMJ) and can be expressed by quantifying the density of tissue using Hounsfield units (HU), which are relatively set based on the value of -1000 for air and 0 for water
Detailed fat fraction (FF) values for the control and TMD groups are shown in S1 and S2 Tables
Summary
CT is an excellent imaging modality for evaluating bony changes of the temporomandibular joint (TMJ) and can be expressed by quantifying the density of tissue using Hounsfield units (HU), which are relatively set based on the value of -1000 for air and 0 for water. MRI is excellent for evaluating soft tissue It shows the soft tissue, including the disc of the TMJ and its attachment, as well as joint effusion and the bone marrow signal of the condylar head [1]. Edema and osteonecrosis in the bone marrow of the mandibular condyle were considered to be a precursor to osteoarthritis, but these changes were not evaluated accurately and quantitatively on routine MRI [5, 9,10,11]. The utility of IDEAL-IQ for the TMJ has not yet been assessed
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