Daniel Talmaceanu1, Lavinia Manuela Lenghel2, Nicolae Bolog3, Roxana Popa Stanila4, Smaranda Buduru5, Daniel Corneliu Leucuta6, Horatiu Rotar7, Mihaela Baciut8, Grigore Baciut9. 1. Department of Cranio-Maxillofacial Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. danieltalmaceanu@yahoo.com. 2. Department of Radiology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. lenghel.manuela@gmail.com. 3. Phoenix Swiss Med GmbH, Switzerland. nbolog@phoenixswissmed.com. 4. Department of Radiology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. roxanatania@yahoo.com. 5. Department of Prosthodontics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. smarandabuduru@yahoo.com. 6. Department of Medical Informatics and Biostatistics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. dleucuta@umfcluj.ro. 7. Department of Cranio-Maxillofacial Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. hrotaru@yahoo.com. 8. Department of Cranio-Maxillofacial Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. mbaciut@umfcluj.ro. 9. Department of Cranio-Maxillofacial Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca. gbaciut@umfcluj.ro.
Abstract
AIMS: The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements. MATERIALS AND METHODS: A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer. RESULTS: MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81. CONCLUSIONS: Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner's skills and on the equipment used.
AIMS: The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements. MATERIALS AND METHODS: A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer. RESULTS: MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81. CONCLUSIONS: Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner's skills and on the equipment used.