Bilateral 4D visualization of human temporomandibular joints using a novel multi-slice real-time MRI procedure - A comparative analysis of the intraoral masticatory forces of subjects with and without anterior disk displacement

使用新型多切片实时 MRI 程序对人类颞下颌关节进行双边 4D 可视化 - 对有和没有前盘移位受试者的口内咀嚼力进行比较分析

• 批准号: 318515842
• 负责人: Dr. Sebastian Krohn
• 金额: --
• 依托单位: Poliklinik für Kieferorthopädie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2021-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/318515842?language=en
• 关键词: Bilateral; 4D; visualization; human; temporomandibular

The aim of the present study is the bilateral dynamic 4D real-time visualization of the temporomandibular joint structures of patients with anterior disk displacement during the chewing process. This includes the simultaneous visualization of both temporomandibular joints over time as well as the three-dimensional positional relationship, the dynamic changes of the discus articularis and all adjacent temporomandibular joint structures. The currently available conventional MRI techniques allow the visualization of static rather than dynamic processes (i.e., mandibular movements) because the corresponding data is not acquired in real time; pseudodynamic MRI sequences are also retrospectively produced only by time-consuming reconstruction of independent static MRI images. Clinically applicable measuring systems for the recording of mandibular pathways, such as the axiography, however, do not allow precise anatomical conclusions on the dynamic changes of the temporomandibular joint structures during movement. The development of real-time MRI technology at the Göttingen MPI for Biophysical Chemistry (Prof. Jens Frahm) enables an MRI acquisition time of approximately 20-60 milliseconds per frame with a high spatial resolution. As part of a collaboration with Prof. Frahm, our group has been able to implement this innovative technique to analyze high-resolution MRI video sequences of the temporomandibular joint in healthy volunteers during the chewing movement. Due to further advances in computer performance (bypass computers), image reconstruction techniques (FLASH, non-linear inverse reconstruction) as well as modified software and hardware components we have now succeeded in acquiring simultaneous bilateral MRI data in several image planes. We would like to apply this extended multi-slice real-time MRI procedure in the project presented here to enable four-dimensional real-time insights into physiological and pathophysiological processes of temporomandibular joint functions. For the first time, the interaction of both temporomandibular joints can be simultaneously visualized in order to investigate the biomechanical influence of unilateral and bilateral pathological changes in temporomandibular joint structures during mastication. This had not previously been an option due to technical limitations. The method presented here represents the state of the art in imaging diagnostics and enables conclusions to about biomechanical relationships in fundamental research on the human temporomandibular joint. By using this novel method, the biomechanics of the temporomandibular joint in subjects with and without disc displacements can be clearly described. On the basis of the results, the hypothesis should be tested that there is larger force on the articular surfaces in subjects with disc displacement in relation to subjects of the control group.

本研究的目的是双侧动态4D实时可视化颞下颌关节结构的患者在咀嚼过程中的前盘移位。这包括随着时间的推移，以及三维位置关系，关节盘和所有相邻的颞下颌关节结构的动态变化的颞下颌关节的同时可视化。当前可用的常规MRI技术允许静态而非动态过程的可视化（即，下颌运动），因为相应的数据不是在真实的时间内采集的;伪动态MRI序列也仅通过独立的静态MRI图像的耗时重建来回顾性地产生。然而，临床上可用于记录下颌路径的测量系统，如轴向成像，不能对运动过程中颞下颌关节结构的动态变化得出精确的解剖学结论。Göttingen MPI生物物理化学（Jens Frahm教授）开发的实时MRI技术实现了每帧约20-60毫秒的MRI采集时间和高空间分辨率。作为与Frahm教授合作的一部分，我们的团队已经能够实施这种创新技术来分析健康志愿者在咀嚼运动期间颞下颌关节的高分辨率MRI视频序列。由于计算机性能（旁路计算机）、图像重建技术（FLASH、非线性逆重建）以及修改的软件和硬件组件的进一步进步，我们现在已经成功地在多个图像平面中同时采集双侧MRI数据。我们希望在这里介绍的项目中应用这种扩展的多切片实时MRI程序，以实现对颞下颌关节功能的生理和病理生理过程的四维实时见解。首次实现了双侧颞下颌关节相互作用的同时可视化，以探讨咀嚼运动中单侧和双侧颞下颌关节结构病理变化的生物力学影响。由于技术限制，这以前不是一个选择。这里提出的方法代表了最先进的成像诊断，并使结论有关的生物力学关系的基础研究对人类颞下颌关节。通过使用这种新的方法，颞下颌关节的生物力学在受试者和无盘位移可以清楚地描述。根据结果，应检验以下假设：与对照组受试者相比，椎间盘移位受试者关节面上的力更大。