EVALUATION OF MRI FOR DIAGNOSIS OF TMJ DISC DISPLACEMENT

MRI 对颞下颌关节盘移位诊断的评估

• 批准号: 3221154
• 负责人: DAVID ROBERTS
• 金额: $ 11.54万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-12-01 至 1992-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3221154
• 关键词: dental disorder diagnosis; diagnosis design /evaluation; human subject; magnetic resonance imaging; noninvasive diagnosis; temporomandibular joint

Current techniques for determining the existence of pathologic morphology in the TMJ, particularly disc derangement disorders, include conventional radiographs, arthrography, and CT. Arthrography is considered by most clinicians to provide the best diagnostic information on soft tissue pathology and has shown high correlation with surgical findings. However, it is painful, invasive and uses moderate levels of ionizing radiation. MRI is an alternative technique which is non-invasive and has no known adverse health effects. It displays the anatomy of most body tissues, but in contrast to x-ray techniques, is particularly effective in imaging soft tissue structures. Further, it is possible that variations in MR signals may be associated with differences in tissue characteristics. We seek to test the hypothesis that MRI is at least as accurate as arthrography in identification of disc derangement. An observer performance study will be conducted utilizing 2 panel of expert readers to independently interpret arthrographic and MR images derived from a population of patients with symptoms of disc derangement. Observer diagnoses will be compared to direct verification in patients who proceed to surgery. To avoid the effects of sample bias on observer performance, data sets will consist of roughly equal proportions of 'normal' and abnormal cases. This investigation will provide quantitative evidence of comparative accuracy, sensitivity, specificity, and inter and intra observer reliability for each method. Further analysis of responses on a range of diagnostic features will identify the specific information which is uniquely or jointly derived from each technique. The effect of MR imaging parameters on observer detection and characterization of TMJ pathology will be studied in equal subsets of normal and abnormal subjects who will be scanned using 4 different sets of pulse sequences. Randomly sequenced images will be read twice by the MRI panel. Accuracy and inter and intra reader reliability will be compared across imaging protocols. Finally, the relationship between MR signal characteristics and histopathology will be studied in a sample of excised TMJ tissue specimens derived from the surgery patients. Tissue relaxation times (T1 and T2) will be correlated with the type and degree of pathologic change observed via histologic examination of the tissue. The results will determine if relaxation time can be used to infer information about meniscal pathology.

目前确定病理形态存在的技术 在TMJ中，特别是椎间盘错乱，包括传统的 X光片、关节造影和CT检查。关节造影术被大多数人认为是 临床医生提供关于软组织的最佳诊断信息 并与手术结果高度相关。然而， 它是痛苦的，侵入性的，使用中等水平的电离辐射。 MRI是一种非侵入性的替代技术，目前尚不清楚 对健康的不利影响。它显示了大多数身体组织的解剖结构，但 与x射线技术相比，它在成像软件方面特别有效 组织结构。此外，有可能MR信号中的变化 可能与组织特征的差异有关。 我们试图验证这样一种假设，即核磁共振成像至少与 关节造影在腰椎间盘突出症鉴别诊断中的应用。观察者 性能研究将利用2个专家小组进行，以 独立解释关节造影和磁共振图像来自 有腰椎间盘错乱症状的患者群体。观察者 诊断将与继续进行治疗的患者的直接验证进行比较 去做手术。为了避免样本偏差对观测器性能的影响， 数据集将包含大致相同比例的“正常”和“ 不正常的案例。这项调查将提供定量的证据 比较准确性、敏感度、特异度以及内部和内部 每种方法的观察者可靠性。进一步分析对一项 一系列诊断功能将识别以下特定信息 是从每种技术中唯一或共同派生出来的。 磁共振成像参数对观察者检测的影响 TMJ病理的特征将在相等的子集中进行研究 正常和异常受试者将使用4组不同的 脉冲序列。随机排序的图像将由MRI读取两次 面板。将比较准确性以及读卡器间和读卡器内的可靠性 跨成像协议。 最后，研究了磁共振信号特征与信号强度之间的关系 组织病理学将在切除的TMJ组织样本中进行研究 来源于手术患者。组织松弛时间(T1和T2) 将与观察到的病理变化的类型和程度相关 通过对组织进行组织学检查。结果将决定是否 松弛时间可以用来推断半月板的病理信息。