Evaluation of condylar osseous changes using a wireless detector with proton density-weighted imaging sequences

Area of Science:

• Radiology
• Medical Imaging
• Orthodontics

Background:

• Cone-beam computed tomography (CBCT) is standard for condylar osseous changes but has radiation risks and poor soft-tissue resolution.
• CBCT is unsuitable for evaluating soft tissues like the articular disc and lateral pterygoid muscle.
• Evaluating condylar changes in temporomandibular disorders (TMD) requires advanced imaging techniques.

Purpose of the Study:

• To assess the feasibility and advantages of using wireless detectors (WD) with proton density-weighted imaging (PDWI) sequences for imaging condyle changes in TMD patients.
• To qualitatively and quantitatively evaluate the diagnostic capabilities of WD-PDWI compared to conventional methods.
• To determine if WD-PDWI can improve the visualization of osseous alterations in the TMJ.

Main Methods:

• Twenty patients with TMD underwent MRI scans using both head/neck coupling coiling (HNCC) and wireless detector-HNCC (WD-HNCC) with PDWI sequences on a 3.0 T scanner.
• Condylar osseous changes were evaluated qualitatively through subjective scoring and quantitatively by comparing contrast-to-noise ratio (CNR).
• Statistical analyses included paired t-tests for CNR, kappa statistics for inter-observer consistency, and paired rank-sum tests for subjective scores.

Main Results:

• Images from WD-HNCC more clearly depicted mandibular osteophyte, bone cortical erosion, subcortical cystic focus, and bone cortical hyperplasia/thickening compared to HNCC.
• WD-HNCC significantly improved image CNR by 158.9% (28.17±16.01) versus HNCC (10.88±6.53; P=0.001).
• Of 40 condyles, 32 showed osseous changes, with WD-HNCC providing superior visualization.

Conclusions:

• Wireless detector-head/neck coupling coiling (WD-HNCC) in PDWI sequences is effective for imaging condylar bone changes in TMD patients.
• This technique significantly enhances image quality, offering clearer visualization of osseous abnormalities.
• WD-PDWI represents a promising advancement for diagnosing TMD-related condylar alterations.