DOI QR코드

DOI QR Code

The Analysis of Incidental Findings on Temporomandibular Joint Magnetic Resonance Imaging

  • Choi, Yoon Joo (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Lee, Chena (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Jeon, Kug Jin (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry) ;
  • Han, Sang-Sun (Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry)
  • Received : 2020.06.17
  • Accepted : 2020.06.25
  • Published : 2020.06.30

Abstract

Purpose: The aim of this study was to investigate the types and frequency of the various incidental findings (IFs) on magnetic resonance images (MRI) taken from the patients with temporomandibular disorder (TMD) symptoms. Materials and Methods: Temporomandibular joint (TMJ) MRI taken from 1,013 patients with TMD symptoms were evaluated retrospectively. IF was defined as imaging features that were accidentally or unexpectedly found, rather than degenerative bony changes of TMJ complex or disc derangement. They were classified into two groups as TMJ site-specific findings and unexpected findings at other regions. The frequency of the sub groups was analyzed. Result: A total of 26 (2.57%) cases with IFs were classified into 13 cases with TMJ site-specific findings and 13 cases with unexpected findings at other region. TMJ site-specific findings included synovial chondromatosis in 6 cases, synovial cyst in 6 cases and osteochondroma in one case. Unexpected findings included salivary gland tumor in 3 cases, developmental cyst in 3 cases, vascular malformation in 2 cases, mastoiditis in 4 cases and sialadenitis on parotid gland in one case. Conclusion: When diagnosing TMD through TMJ MRI, clinicians should carefully read the image, considering the possibility of IFs because TMJ MRI can provide pathologic information in TMJ region and other oral and maxillofacial region.

Keywords

References

  1. Okeson JP. Management of temporomandibular disorders and occlusion. 4th ed. St. Louis: Mosby; 1998.
  2. Bavitz JB, Chewning LC. Malignant disease as temporomandibular joint dysfunction: review of the literature and report of case. J Am Dent Assoc. 1990; 120: 163-6. https://doi.org/10.14219/jada.archive.1990.0041
  3. Heo MS, An BM, Lee SS, Choi SC. Use of advanced imaging modalities for the differential diagnosis of pathoses mimicking temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 630-8. https://doi.org/10.1016/S1079-2104(03)00373-1
  4. Miyamoto H, Matsuura H, Wilson DF, Goss AN. Malignancy of the parotid gland with primary symptoms of a temporomandibular disorder. J Orofac Pain. 2000; 14: 140-6.
  5. Epstein JB, Caldwell J, Black G. The utility of panoramic imaging of the temporomandibular joint in patients with temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 236-9. https://doi.org/10.1067/moe.2001.114158
  6. Mawani F, Lam EW, Heo G, McKee I, Raboud DW, Major PW. Condylar shape analysis using panoramic radiography units and conventional tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99: 341-8. https://doi.org/10.1016/j.tripleo.2004.07.011
  7. Hussain AM, Packota G, Major PW, Flores-Mir C. Role of different imaging modalities in assessment of temporomandibular joint erosions and osteophytes: a systematic review. Dentomaxillofac Radiol. 2008; 37: 63-71. https://doi.org/10.1259/dmfr/16932758
  8. dos Anjos Pontual ML, Freire JS, Barbosa JM, Frazao MA, dos Anjos Pontual A. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol. 2012; 41: 24-9. https://doi.org/10.1259/dmfr/17815139
  9. Morales H, Cornelius R. Imaging approach to temporomandibular joint disorders. Clin Neuroradiol. 2016; 26: 5-22. https://doi.org/10.1007/s00062-015-0465-0
  10. Tasaki MM, Westesson PL. Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology. 1993; 186: 723-9. https://doi.org/10.1148/radiology.186.3.8430181
  11. Yanagi Y, Asaumi J, Maki Y, Murakami J, Hisatomi M, Matsuzaki H, Konouchi H, Honda Y, Kishi K. Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis. Eur J Radiol. 2003; 47: 6-9. https://doi.org/10.1016/S0720-048X(03)00095-0
  12. Makdissi J, Pawar RR, Radon M, Holmes SB. Incidental findings on MRI of the temporomandibular joint. Dentomaxillofac Radiol. 2013; 42: 20130175. https://doi.org/10.1259/dmfr.20130175
  13. Orhan K, Avsever H, Aksoy S, Seki U, Bozkurt P. Temporomandibular joint MR images: incidental head and neck findings and pathologies. Cranio. 2019; 37: 121-28. https://doi.org/10.1080/08869634.2017.1383744
  14. Kamio T, Yakushiji T, Takaki T, Shibahara T, Imoto K, Wakoh M. Incidental findings during head and neck MRI screening in 1717 patients with temporomandibular disorders. Oral Radiol. 2019; 35: 135-42. https://doi.org/10.1007/s11282-018-0327-y
  15. Mirilas P, Skandalakis JE. Benign anatomical mistakes: incidentaloma. Am Surg. 2002; 68: 1026-8.
  16. Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res. 2012; 23: 1261-8. https://doi.org/10.1111/j.1600-0501.2011.02299.x
  17. Harms SE, Wilk RM, Wolford LM, Chiles DG, Milam SB. The temporomandibular joint: magnetic resonance imaging using surface coils. Radiology. 1985; 157: 133-6. https://doi.org/10.1148/radiology.157.1.4034958
  18. Manoliu A, Spinner G, Wyss M, Filli L, Erni S, Ettlin DA, Ulbrich EJ, Kuhn FP, Gallo LM, Andreisek G. Comparison of a 32-channel head coil and a 2-channel surface coil for MR imaging of the temporomandibular joint at 3.0 T. Dentomaxillofac Radiol. 2016; 45: 20150420. https://doi.org/10.1259/dmfr.20150420
  19. Held P, Moritz M, Fellner C, Behr M, Gmeinwieser J. Magnetic resonance of the disk of the temporomandibular joint. MR imaging protocol. Clin Imaging. 1996; 20: 204-11. https://doi.org/10.1016/0899-7071(95)00018-6
  20. Honda E, Sasaki T, Simm FC, Maruyama K. An optimized fast protocol for magnetic resonance imaging of the temporomandibular joint. Dentomaxillofac Radiol. 2001; 30: 126-30. https://doi.org/10.1038/sj/dmfr/4600580
  21. Illes J, Rosen AC, Huang L, Goldstein RA, Raffin TA, Swan G, Atlas SW. Ethical consideration of incidental findings on adult brain MRI in research. Neurology. 2004; 62: 888-90. https://doi.org/10.1212/01.WNL.0000118531.90418.89