Zusammenfassung.
Vorstellung der optimierten Untersuchungstechnik zur magnetresonanztomographischen
(MRT) Evaluation des Temporomandibulargelenkes (TMG) und Darstellung der Ergebnisse
und Indikationsstellung. Es werden die Spulentechnik, das Sequenzdesign, die Schichtorientierung
und der programmierte Untersuchungsablauf in Abhängigkeit von der klinischen Fragestellung
präsentiert. In Abhängigkeit von der klinischen Symptomatik stellt die MRT das primäre
bildgebende Verfahren zur Diagnostik und Therapiekontrolle degenerativer, entzündlicher
und tumoröser Prozesse des TMG dar. In Einzelfällen müssen ergänzend weitere radiologische
Techniken wie die Orthopantomographie, die direkte Arthrographie und die Computertomographie
zum Einsatz kommen. Die optimierte MRT des TMG erfordert eine dedizierte Untersuchungstechnik
sowie spezielle Kenntnisse in der Beurteilung der akquirierten Bilder.
MRI of the temporomandibular joint. Technique, results, indications.
An optimized examination protocol for the MRI evaluation of the temporomandibular
joint (TMJ) is presented. The MRI protocol is based on an optimized coil technology,
sequence design, and a programmed examination protocol for diagnostics of the TMJ.
Depending on the clinical findings, MRI provides an all-in-one diagnostic protocol
for the diagnosis of degenerative, inflammatory and tumorous lesions of the TMJ. MRI
using an optimized examination protocol should become the primary examination protocol
for diseases of the TMJ.
Schlüsselwörter:
Temporomandibulargelenk (TMG) - MRT - Diskoligamentäre Dysfunktion
Key words:
Temporomandibular joint (TMJ) - MRI - Internal derangement
Literatur
- 1
Raustia A M, Pyhtinen J, Virtanen K K.
Examination of the temporomandibular joint by direct sagittal computed tomography.
Clin Radiol.
1985;
36
291-296
- 2 Sperber G H. Embryologie des Kopfes. Berlin; Quintessenz Verlag 1992
- 3 Benninghoff A. Anatomie Band 1. München; Urban & Fischer Verlag 1999
- 4
Steenks M H, Bleys R L, Witkamp T D.
Temporomandibular joint structures: a comparison between anatomic and magnetic resonance
findings in a sagittal and an angulated plane.
J Orofac Pain.
1994;
8
120-135
- 5
Steenks M H, Bleys R L, Witkamp T D.
Temporomandibular joint structures: a comparison between anatomic and magnetic resonance
findings in a coronal and an angulated coronal plane.
J Orofac Pain.
1994;
8
335-349
- 6
Orsini M G, Kuboki T, Terada S, Matsuka Y, Yamashita A, Clark G T.
Diagnostic value of 4 criteria to interpret temporomandibular joint normal disk position
on magnetic resonance images.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod.
1998;
86
489-497
- 7
Bundesausschuss der Ärzte und Krankenkassen .
Richtlinien über Kriterien zur Qualitätsbeurteilung in der Kernspintomographie.
DÄB.
2001;
98
A 786-A 795
- 8
Vogl T J, Eberhard D, Bergman C, Lissner J.
Incremental hydraulic jaw opener for MR imaging of the temporomandibular joint.
J Magn Reson Imaging.
1992;
2
479-482
- 9
Burnett K R, Davis C L, Read J.
Dynamic display of the temporomandibular joint meniscus by using „fast-scan” MR imaging.
Am J Roentgenol.
1987;
149
959-962
- 10
Maniere-Ezvan A, Havet T, Franconi J M, Quemar J C, de Certaines J D.
Cinematic study of temporomandibular joint rnotion using ultra-fast magnetic resonance
imaging.
Cranio.
1999;
17
(4)
262-267
- 11
Eriksson L, Westesson P L, Macher D, Hicks D, Tallents R H.
Creation of Disc Displacement in Human Temporomandibular Joint Autopsy Specimens.
J Oral Maxillofac Surg.
1992;
50
869-873
- 12
Suenaga S, Abeyama K, Noikura T.
Gadolinium-enhanced MR imaging of temporomandibular disorders: improved lesion detection
of the posterior disk attachment on T1-weighted images obtained with fat suppression.
Am J Roentgenol.
1998;
171
511-517
- 13
Suenaga S, Ogura T, Matsuda T, Noikura T.
Severity of synovium and bone marrow abnormalities of the temporomandibular joint
in early rheumatoid arthritis: role of gadolinium-enhanced fat-suppressed T1-weighted spin echo MRI.
J Comput Assist Tomogr.
2000;
24
461-465
- 14
Miyamoto H, Sakashita H, Wilson D F, Goss A N.
Synovial chondromatosis of the temporomandibular joint.
Br J Oral Maxillofac Surg.
2000;
38
205-208
- 15
Bergman H, Andersson F, Isberg A.
Incidence of ternporomandibular joint changes after whiplash trauma: a prospective
study using MR imaging.
Am J Roentgenol.
1998;
171
1237-1243
- 16
Linge C, Prager T M.
TMJ morphology and function in a patient with Klippel-Trenaunay syndrome. Case report.
J Orofac Orthop.
2000;
61
217-221
- 17 Vogl T J. Die Radiologische Differentialdiagnose in der Kopf-Hals-Region. Stuttgart;
Thieme 1998: 254-286
- 18
Palacios E, Valvassori G.
Masticator space tumor, malignant schwannoma.
Ear Nose Throat J.
2000;
79
550
- 19
Koumoura F, Contoes N.
Meningioma manifested as temporomandibular joint disorder: a case report.
Int Dent J.
2000;
50
109-111
- 20
Jagger R G, Helkimo M, Carlsson G E.
Multiple myeloma involving the temporomandibular joint: report of case.
J Oral Surg.
1978;
36
557-559
- 21
Grinin V M.
[The involvement of the temporomandibular joints in multipie myeloma].
Stomatologiia (Mosk).
1997;
76
75-76
- 22
Abolmaali N, Kittner T, Foerster A, Wandelt T, Pinkert R, Platzbecker H.
MRI of the temporo-mandibular joint in patients with disc displacement: Follow-up
of non-surgical therapy.
European Radiology.
2000;
10
(Suppl 1)
112-113
- 23
Kurita K, Goss A N, Ogi N, Toyama M.
Correlation between preoperative mouth opening and surgical outcome after arthroscopic
lysis and lavage in patients with disc displacement without reduction.
J Oral Maxillofac Surg.
1998;
56
1394-1397
- 24
Sato S, Goto S, Kawamura H, Motegi K.
The natural course of nonreducing disc displacement of the TMJ: Relationship of clinical
findings at initial visit to outcorne after 12 months without treatment.
J Orofac Pain.
1997;
11
315-320
- 25
Sato S, Sakamoto M, Kawamura H, Motegi K.
Long-term changes in clinical signs and symptoms and disc position and morphology
in patients with nonreducing disc displacement in the temporomandibular joint.
J Oral Maxillofac Surg.
1999;
57
23-29
Prof. Dr. med. Thomas J. Vogl
Institut für Diagnostische und Interventionelle Radiologie
J. W. Goethe-Universität Frankfurt
Theodor-Stern-Kai 7
60590 Frankfurt
Phone: 069/6301-7277
Fax: 069/6301-7258
Email: T.Vogl@em.uni-frankfurt.de