Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging

To determine the diagnostic accuracy, sensitivity, and specificity of magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) in the assessment of disk position, disk form, and changes in the osseous components, 55 fresh cadaver joints were imaged. A 1.5-T imager was used in the sagittal and coronal planes. After MR imaging, the joints were cryosectioned in the coronal plane corresponding to the coronal image through the center of the joint. The joints were then remounted and sectioned serially in the sagittal plane from lateral to medial, corresponding to the sagittal MR images. MR images were interpreted by the two authors together, without knowledge about cryosectional findings. The cryosections were interpreted by the authors together, without knowledge of the MR imaging findings. MR imaging was 95% accurate in the assessment of disk position and disk form and 93% accurate in the assessment of osseous changes. Coronal images helped avoid a false-negative diagnosis in 13% (n = 7) of the joints. MR imaging with a surface coil appears to be an accurate method for the assessment of soft and hard tissues of the TMJ.