Evaluation of temporomandibular joint osteoarthritis using a new FRACTURE sequence of 3.0T MRI

The purpose of this study was to determine the usefulness of a new MRI sequence, CT-like fast field echo with limited echo-spacing (FRACTURE), in diagnosing temporomandibular joint (TMJ) osteoarthritis compared with routine MRI TMJ sequences.

The study sample comprised 76 patients (152 joints) who underwent MRI and CT examinations to diagnose TMJ disorders. Two specialists in oral and maxillofacial radiology assessed the bony changes of the TMJ on FRACTURE, proton density-weighted (PDw), and fat-suppression T2-weighted (T2wFS) sequences. Receiver operating characteristic curves were plotted for each sequence, and the accuracy, sensitivity, specificity, and area under the curve (AUC) were calculated. Additionally, the interobserver agreement (Cohen's kappa value) and sensitivity in assessing each osteoarthritis finding were calculated for each sequence.

The FRACTURE sequence had the highest diagnostic performance, with an accuracy of 0.85, sensitivity of 0.85, specificity of 0.84, and AUC of 0.84. These values were 0.84, 0.72, 0.91, and 0.80, respectively, for the PDw sequence, and 0.83, 0.72, 0.91, and 0.79, respectively, for the T2wFS sequence. The AUC did not significantly differ between the FRACTURE and PDw sequences (Delong test, P > .05), but did significantly differ between the FRACTURE and T2wFS sequences (P < .05). For all osteoarthritis findings, the FRACTURE sequence had the highest kappa values and the highest sensitivity.

FRACTURE sequencing may be a promising tool for the diagnosis of TMJ osteoarthritis compared with other conventional sequences.