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Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
A nomogram for classification of temporomandibular joint disk perforation based on magnetic resonance imaging
Jae-Young Kim1, Kug-Jin Jeon2, Myeong-Gyun Kim1
1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Objective:
The aim of this study was to analyze risk factors and establish a prediction model for temporomandibular joint (TMJ) disk perforation by constructing a nomogram.
Study Design:
The study included a total of 282 joints in 274 patients. All patients underwent open TMJ surgery after obtaining magnetic resonance imaging (MRI), from 2005 to 2015. The presence or absence of disk perforation was confirmed during the operation. Patients were classified into 2 groups: perforation and nonperforation groups. We investigated demographic data and the characteristics of the disk, joint space, and bone on MRI. A logistic regression analysis was performed to analyze risk factors. A nomogram was constructed and validated internally and externally.
Results:
Risk factors for disk perforation were increased age, disk shape (eyeglass or amorphous), low bone marrow signal, abnormal joint space, and 2 or more bony changes in the condyle and fossa. The area under the receiver operating characteristic curve of the nomogram was 0.908 (95% confidence interval [CI] 0.869-0.946) in the internal validation and 0.889 (95% CI 0.804-0.973) in the external validation with good suitability.
Conclusions:
We were able to predict the probability of disk perforation with analyzed risk factors and constructed a nomogram, which may be helpful in proper diagnosis and treatment.
Insights
This study identified key risk factors for temporomandibular joint (TMJ) disk perforation, developing a nomogram to predict perforation probability. This tool aids in TMJ disorder diagnosis and treatment planning.
Area of Science:
- Temporomandibular Joint Disorders
- Medical Imaging
- Surgical Risk Assessment
Background:
- Temporomandibular joint (TMJ) disk perforation is a significant condition often requiring surgical intervention.
- Accurate prediction of TMJ disk perforation is crucial for effective patient management.
Purpose of the Study:
- To identify and analyze risk factors associated with TMJ disk perforation.
- To develop and validate a predictive model (nomogram) for TMJ disk perforation.
Main Methods:
- Retrospective analysis of 282 TMJ surgeries in 274 patients (2005-2015).
- Magnetic resonance imaging (MRI) evaluation of demographic data, disk morphology, joint space, and bone characteristics.
- Logistic regression analysis to determine risk factors; nomogram construction and internal/external validation.
Main Results:
- Identified risk factors: increased age, specific disk shapes (eyeglass, amorphous), low bone marrow signal, abnormal joint space, and multiple bony changes.
- The developed nomogram demonstrated high predictive accuracy (AUC 0.908 internally, 0.889 externally).
Conclusions:
- A validated nomogram effectively predicts TMJ disk perforation probability based on analyzed risk factors.
- The nomogram can assist clinicians in diagnosis and treatment planning for TMJ disorders.
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