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Temporomandibular-joint

MRI TMJ protocols

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Temporomandibular-joint

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  1. Temporomandibular Joint MRI Protocols of the ESSR Arthri<s Subcommi=ee Recommenda<ons of the ESSR Arthri<s Subcommi=ee for the Use of Magne<c Resonance Imaging in Musculoskeletal Rheuma<c Diseases. Semin Musculoskelet Radiol 2015;19:396–411

  2. Acronyms Ax= axial CE= contrast enhanced Cor= coronal FOV= field of view FS= fat suppressed PD= proton density Sag= sagi=al TE= echo <me (ms) TMJ= Temporomandibular joint TR= repe<<on <me (ms)

  3. MRI scan •  Pa<ent in supine posi<on with the head first •  Head coil

  4. Localizer: Inflammatory disease Axial plane: refer to the sagi=al plane, orient the scan parallel to the hard palate and cover the en<re TMJ from the corpus callosum up to the angle of the jaw. If the head is <lted, the angula<on has to be adjusted on the coronal plane. Sagi0al plane: refer to the axial plane, orient the scan perpendicular to the condyle of the mandible (i.e., of the same side that has to be examined). Check the correct posi<oning on the other two planes. If the head is <lted, the angula<on has to be adjusted on the coronal plane. Coronal plane: refer to the axial plane, orient the scan parallel to the condyle of the mandible (i.e., of the same side that has to be examined). Check the correct posi<oning on the sagi=al plane.

  5. Recommended Sequences: Inflammatory disease Cor T2 FS (or STIR or TIRM) Cor T1 (or Ax T1) Ax T2 FS (or STIR or TIRM) Cor T2

  6. Localizer: Joint derangement Sagi0al oblique: -  refer to the axial plane -  orient the scan perpendicular to the condyle of the mandible (i.e., of the same side) -  check the correct posi<oning on the other two planes -  the number of slices has to cover the joint from side to side The MR scan has to be performed: •  with the mouth opened and closed •  on the right and on the lea TMJ

  7. Recommended Sequences: Joint derangement Sag oblique PD FS mouth closed Sag oblique PD FS mouth opened

  8. Recommended Sequences: Joint derangement Sag oblique PD mouth closed Sag oblique PD mouth opened

  9. MRI protocols Recommended Sequences FOV (mm) Slice thickness (mm) 3 TR (ms) TE (ms) Matrix Cor T1 230 420-620 10 256x256 Inflammatory disease Ax T2 230 5 2500-5500 90 256x256 Cor T2 FS 230 3 2500-5000 100 256x256 Cor T2 230 3 2200-3200 100 256x256 CE T1 FS (for synovi<s and/or ostei<s) PD FS oblique mouth closed & opened PD oblique mouth closed & opened 140 2.5 420-620 10 256x256 140 2.5 2200-3200 24 256x256 derangement Joint 140 2.5 2200-3200 24 256x256

  10. Contributors •  Andrea Klauser, Austria •  Iwona Sudoł-Szopińska, Poland Project Coordinators •  Chiara Giraudo, Italy •  Hannes Platzgummer, Austria

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