To Explore The Clinical Value Of Wireless Amplified MRI Detector In Temporomandibular Joint Disorders

Objective:To explore the feasibility of high definition imaging of temporomandibular joint(TMJ)with wireless amplified MRI detector(WAND)coupled with conventional head and neck joint coil and its clinical value in temporomandibular joint disorders(TMD)Methods:1.Feasibility study of TMJ high-definition imaging based on WAND:15healthy young volunteers from November to December 2019 were performed bilateral TMJ conventional head and neck joint coil and WAND coupled conventional head and neck joint coil proton density weighted image(PDWI).The subjective and objective evaluation of the two groups of images included articular disc,anterior attachment,posterior attachment,articular cavity,double plate area and condylar bone,and the objective evaluation included image signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR).Paired rank sum test was used to compare the subjective scores of TMJ anatomical structures in two kinds of scanned images,and Kappa test was used to evaluate the consistency of two imaging diagnostics in evaluating the anatomical structures of TMJ.2.Study on the clinical value of WAND in TMD:85 patients with TMD diagnosed by oral and maxillofacial surgeons from October 2019 to January 2022were collected.All subjects underwent open,closed oblique sagittal and coronal WAND coupled head and neck coils.20 patients underwent CT(16 of cone beam computed tomography(CBCT)and 4 of multi-slicespiral computed tomography(MSCT)).The clinical value of WAND high definition imaging in the evaluation of condylar bone:take CT examination as the"gold standard"to evaluate the consistency of WAND coupled head and neck coil MRI high definition imaging in showing condylar bone changes,and the consistency of the two imaging methods was tested by Kappa test;to evaluate the clinical value of lateral pterygoid muscle(LPM)attachment type in TMD patients with TMD by WAND high definition imaging:based on TMJ and LPM high definition imaging,to explore the correlation between LPM attachment type in TMD patients and MRI imaging findings in TMD patients.TMD imaging findings include temporomandibular joint osteoarthritis(TMJOA),articular disc position,articular disc morphology,articular cavity effusion.χ~2 test and Pearson correlation analysis were used to evaluate the correlation between LPM attachment type and TMD image performance.Results:1.Feasibility study of TMJ high-definition imaging based on WAND:compared with conventional head-neck joint coil scanning TMJ images,there were significant differences in SNR and CNR images obtained by WAND coupled head-neck joint coil high-definition TMJ scanning(t=9.7,P<0.05;t=6.28,P<0.05).The average SNR of WAND high-definition group was 28.76±4.21,which was 95.6%higher than that of conventional group.The average CNR of WAND high definition group was60.58±13.95,which was 110.6%higher than that of routine group.Subjective evaluation showed that WAND imaging was better for TMJ articular disc,anterior attachment,posterior attachment,articular cavity,double plate area and condylar bone(P<0.05).The subjective scores of the above structures were increased by 35.7%,42.4%,63.5%,48.8%and 39.9%,respectively.2.Study on the clinical value of WAND:compared with CT,40 cases of TMJ WAND coupled head and neck coil imaging were more consistent in showing condylar bone changes(the Kappa values of osteosclerosis,erosion,osteophyte and cystic changes were 0.741,0.845,0.897 and 0.632 respectively,P<0.05);evaluating the attachment type of LPM in TMD patients in TMD patients:there was a significant correlation between LPM attachment type and articular disc position and TMJOA(χ~2=28.2,P<0.05;r=0.776).There was a significant correlation between LPM attachment type and articular disc morphology,but there was no significant correlation between LPM attachment type and articular disc morphology and articular cavity effusion(P>0.05).Conclusion:The use of WAND coupled with conventional head and neck joint coil MRI high-definition scanning can significantly improve the quality of TMJ imaging and improve the ability to display the fine anatomical structure of TMJ.WAND coupled with conventional head and neck joint coil TMJ high-definition scan can provide reliable imaging evidence for the evaluation of LPM attachment type,TMD imaging findings,especially condylar bone changes in patients with TMD.