Static and dynamic MR imaging in the evaluation of temporomandibular disorders

OBJECTIVE: The aim of this study is to prove if dynamic HASTE (half-Fourier acquisition single-shot turbo spin-echo) se - quences can be used in the diagnosis of internal derangement disorders of temporomandibular joint (TMJ) as an alternative to static proton den - sity (PD) weighted/turbo spin echo (TSE) T2- weighted sequences which are considered up to now as the gold standard in the evaluation of TMJdisorders(TMDs). PATIENTS AND METHODS: 194patientsforato - talof388TMJswereexaminedwitha1.5Teslafield strength superconducting magnet. Sagittal static PD-weighted/TSE T2-weighted and dynamic HASTE sequences have been used.Three experts in the field of oral radiology (specialist A, B and C) independently and blinded to clinical symptoms and any treatment, assessed the articular disc po - sition in each TMJ (rated as normal or disc dis - placement with reduction or disc displacement without reduction). The agreement between static and dynamic images and between the three differ - ent specialists in the assessment of the articular discpositionwasevaluatedusingkappastatistic. RESULTS: The agreement between static and dynamic images is: for specialist A, K = 0.862; for specialist B, K = 0.870 and for specialist C, K =0.862. CONCLUSIONS: Since there is no complete agreement between these two MR techniques, dynamic sequences can not be used as a reli - able alternative to static sequences in the evalu - ationofinternalderangementdisordersofTMJ.