Feasibility of a Shortened Dental-dedicated Magnetic Resonance Imaging Acquisition Protocol for Dentomaxillofacial...

Dental-dedicated magnetic resonance imaging (ddMRI) offers hard and soft tissue visualization and inflammatory condition assessment without ionizing radiation. This study evaluated the feasibility of a shortened ddMRI acquisition protocol for general dentomaxillofacial assessment (GDA) and apical periodontitis (AP).

Two diagnostic tasks were investigated: GDA and AP screening (APS). Ten healthy volunteers were assessed for GDA. Ten other patients presenting clinical signs and/or symptoms of AP and requiring cone-beam computed tomography for diagnosis or treatment planning were invited and nine were included. All included teeth underwent clinical examination (pulp testing and periapical radiography) to establish the standard diagnosis for AP presence/absence; after cone-beam computed tomography evaluation, the combined findings defined the reference standard for each tooth. ddMRI examinations were acquired using two pulse sequences: anatomy 3D overview for GDA and inflammation 3D overview for APS. Three trained observers independently evaluated all ddMRI datasets for image quality (5-point Likert scale), anatomical conspicuity of 8 structures (dichotomous scale, GDA), and periapical oedema (dichotomous scale, APS). Statistical analysis included interobserver agreement, intermodality agreement, and diagnostic accuracy metrics.

For GDA (n = 10), ddMRI anatomy protocol yielded good overall image quality and perfect inter-observer agreement, with all anatomical structures, except the periodontal ligament, consistently visible. For APS (n = 18), ddMRI provided acceptable image quality and substantial agreement with the standard diagnosis (accuracy, 0.89; sensitivity, 0.92; and specificity, 0.83).

Shortened ddMRI acquisition protocol is a feasible alternative for simultaneously visualizing hard and soft tissues with promising diagnostic accuracy for periapical inflammation screening.