Dynamic MRI imaging of the TM joint

Current MR technology allows dynamic near-cinematic imaging of the disc. We have found that these studies have provided information additive to routine static imaging in some cases. 26 Advantages include a near real-time assessment of the true range of motion, shortduration of acquisition (35 seconds), and the ability to acquire imaging in a head coil without a dedicated jaw-opening appliance, which allows it to be included in most imaging protocols. Despite a reduced matrix, the disc and its relative position are well assessed . A side benefit of the half-Fourier acquisition single-shot turbo spino-echo (HASTE) imaging protocol is generally reduced susceptibility artifact, which can improve diagnostic yield in the setting of extensive dental hardware.
As imaging is performed in a direct sagittal plane, and not a sagittal oblique plane, the position of the disc is assessed by observing the intermediate zone. One expects its position to be interposed between the radial centers of the articular eminence and the mandibular condyle. In the setting of anterior disc displacement, the authors have seen dynamic imaging findings of visualization of reduction of disc material and of bulging of the anterior margin of the anterior band , even in cases where routine static imaging is normal. On dynamic imaging, a normal range of motion is present when the condyle has translated to the apex of the articular eminence. Normal individuals will often be able to translate beyond this point on a transient basis.

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