MRI is a reliable tool for the detection of TMJ disc perforations, reveals study

This study aimed to evaluate the reliability of magnetic resonance imaging (MRI) in detecting disc perforations in the temporomandibular joint (TMJ), and to establish diagnostic criteria for this purpose. The retrospective analysis included patients who had undergone preoperative MRI and TMJ arthroscopy at the same hospital. Direct and indirect signs of disc abnormalities on MRI were compared with arthroscopic findings of disc perforation. Out of 355 joints evaluated in 185 patients, arthroscopy confirmed disc perforations in 14.7% of cases. Several MRI findings were significantly associated with disc perforation, including anterior disc displacement without reduction (ADDwoR), signal alterations in the mid-disc area, disc deformity (SAMD), retro condylar disc fragments, osteophytes, condylar bone marrow degeneration (CBMD), and joint effusion in both joint spaces (ESJS-EIJS). Regression analysis revealed that SAMD, osteophytes, and CBDM were strongly associated with disc perforation. The ROC curve showed that MRI had an AUC = 0.791, with a sensitivity of 88.5% and a specificity of 61.5%. Two diagnostic methods, one based on three findings (osteophytes, ADDwoR, and SAMD) and one based on two direct signs (ADDwoR and SAMD), yielded high sensitivity and specificity values of 80.4% and 69.8%, and 84.3% and 62.5%, respectively. In conclusion, MRI demonstrated acceptable accuracy in detecting TMJ disc perforations, with specific diagnostic criteria offering high sensitivity and specificity. Significant MRI indicators of disc perforation included SAMD, osteophytes, and CBDM. This study provides valuable information on the use of MRI as a diagnostic tool for TMJ disc perforations.

Reference:

Alejandrina Millón Cruz, Rafael Martin-Granizo, Simona Barone, Luis Miguel Pérez Rodríguez, Salomé Merino Menéndez, Farzin Falahat Noushzady, Javier Arias Díaz,

Reliability of magnetic resonance for temporomandibular joint disc perforation: A 12 years retrospective study. Journal of Cranio-Maxillofacial Surgery. Volume 52, Issue 5,

2024, Pages 548-557, ISSN 1010-5182. https://doi.org/10.1016/j.jcms.2024.04.005.

(https://www.sciencedirect.com/science/article/pii/S1010518224001434)

Keywords:

MRI, reliable tool, detection, TMJ disc, perforations, study, Journal of Cranio-Maxillofacial Surgery, Magnetic resonance imaging; Temporomandibular joint; disc perforation; Arthroscopy, Alejandrina Millón Cruz, Rafael Martin-Granizo, Simona Barone, Luis Miguel Pérez Rodríguez, Salomé Merino Menéndez, Farzin Falahat Noushzady, Javier Arias Díaz