ABSTRACT
OBJECTIVE: To test real-time MRI (rtMRI) using HASTE sequences in patients with suspected internal disk derangement (IDD) of temporomandibular joint (TMJ) and to compare these sequences with standard static sequences. METHODS AND MATERIALS: 99 TMJ were studied with both standard sequences (fat-saturated proton density) and HASTE sequences with high temporal resolution. Image quality was assessed using a 4-point Likert scale. Two radiologists analysed both standard and rtMRI sequences separately, randomly and blinded (by a third operator) to patients' names in order to assess inter-observer repeatability. One of the radiologists performed the analysis twice for assessing intra-observer repeatability. The same radiologists evaluated randomly and blinded to the previous assessment both the sequences and decided in consensus which was the most credible. Qualitative scores were compared using Friedman's test while concordance between radiologists and sequences was evaluated using the concordance correlation coefficient. RESULTS: At image quality analysis, mean score was 3.41 for static MRI and 3.82 for rtMRI, with a statistically significant difference in favour of rtMRI (p < 0.0001). Inter-rater concordance between operator 1 (Op1) and operator 2 (Op2) with regard to the same sequence was high for both static and rtMRI sequences (0.824 and 0.888, respectively). Inter-rater variability of Op1 and Op2 between static and rtMRI sequences was lower (0.647 for Op1 and 0.633 for Op2). Among 71 discordances between sequences, 60 were judged in favour of rtMRI, while 11 were in favour of static MRI. CONCLUSION: rtMRI with HASTE sequences is a robust technique and provide additional information in assessing IDD compared to static sequences.
Subject(s)
Joint Dislocations , Temporomandibular Joint Disorders , Feasibility Studies , Humans , Magnetic Resonance Imaging , Reference Standards , Temporomandibular Joint/diagnostic imaging , Temporomandibular Joint Disorders/diagnostic imagingABSTRACT
In the article "Magnetic resonance imaging features of the superior cervical ganglion and expected changes after radiation therapy to the head and neck in a long-term follow-up", one of the author names, K Chokkappan, was spelled incorrectly.
ABSTRACT
PURPOSE: This study aimed to assess the magnetic resonance (MRI) features of the superior cervical ganglion (SCG) and to track changes to it induced using radiotherapy across a long-term follow-up. METHODS: In total, 75 patients who underwent radiotherapy for head and neck malignancies and who were studied with MRI were recruited from two centers. MRI was performed before and after radiotherapy, with a median long-term follow-up of 4.5 years. Baseline SCG features were assessed. Changes in axial cross-sectional area, T2-normalized signal, and apparent diffusion coefficient (ADC) (the latter available in about half of the patients) were analyzed. Repeated measures analysis of variance with Bonferroni's correction was used to analyze changes in the aforementioned parameters (significance level 0.05). RESULTS: Out of a potential 149 SCGs, 136 were visible at baseline MRI. A variable spatial relationship with the internal carotid artery was found. SCGs showed the "black dot" sign in almost all of the patients. ADC was higher in SCGs than in regional lymph nodes. Cross-sectional area, normalized T2, and ADC increased in the period up to 1 year after radiotherapy and then remained stable in subsequent longer-term follow-up. CONCLUSION: The SCG has unusual features that allow differentiation from the regional lymph nodes. Changes in morphology and signal after radiotherapy must be taken into account by radiologists to avoid misdiagnosis as recurrent nodal disease. Changes induced using radiotherapy are stable in long-term follow-up and are thus likely attributed to other factors (such as Schwann cell hypertrophy/proliferation) rather than edema.
