MRI-guided injection procedures of the temporomandibular joints in children and adults: technique, accuracy, and safety.

摘要

OBJECTIVE: The purpose of our study was to test the hypothesis that real-time MRI-guided, selective injection procedures of the temporomandibular joints are feasible, accurate, and safe when performed on a clinical open-bore 1.5-T MR system. MATERIALS AND METHODS: A retrospective analysis of 67 injection procedures of the temporomandibular joints (55% [37/67] were therapeutic injections, 27% [18/67] were diagnostic injections, and 18% [12/67] were arthrocentesis procedures), performed in 31 patients (58% [18/31] female, 42% [13/31] male; mean age, 14 years; age range, 3-34 years), was made. Seven of 38 (18%) subjects had two temporally separate procedures. Determinations of skin entry points, puncture, and injection were performed under real-time MRI. Data were assessed for rate of successful injections, quantitative and qualitative image quality, time requirements, and occurrence of complications. RESULTS: Drug delivery was successful in all procedures. The quality of real-time FLASH 2D MR images was sufficient in all cases. Real-time MRI proved to be helpful to achieve high rates of intraarticular injections. Contrast-to-noise ratios were sufficiently high for good delineation of relevant structures. Average length of time was 25 minutes (range, 16-53 minutes). No major complications occurred. CONCLUSION: We accept the hypothesis that real-time MRI-guided selective injection procedures of the temporomandibular joints are feasible, accurate, and safe when performed on a clinical open-bore 1.5-T MR system.