GADOLINIUM-ENHANCED MR-IMAGING OF TEMPOROMANDIBULAR DISORDERS - IMPROVED LESION DETECTION OF THE POSTERIOR DISK ATTACHMENT ON T1-WEIGHTED IMAGES OBTAINED WITH FAT-SUPPRESSION

OBJECTIVE. The purpose of this study was to assess the potential for i mproved lesion detection in the posterior disk attachment and its surr ounding tissue in temporomandibular disorders when gadolinium-enhanced MR imaging performed with fat suppression is used. MATERIALS AND METH ODS. Forty-five patients underwent MR imaging with conventional T1- an d T2-weighted, gadolinium-enhanced T1-weighted, and gadolinium-enhance d fat-suppressed spin-echo imaging sequences. Qualitative and quantita tive assessments of the contrast enhancement of each type of imaging w ere also performed. RESULTS. The contrast-enhanced fat-suppressed T1-w eighted imaging sequence had several advantages over the other imaging techniques in detecting abnormalities of the posterior disk attachmen t and in detecting bone marrow lesions in the mandibular condyle. The most significant advantage was better enhancement of lesion conspicuit y. The diagnostic accuracy of contrast-enhanced fat-suppressed imaging was 77% versus 70% for conventional contrast-enhanced imaging, The ka ppa value for interobserver agreement was .95 for contrast-enhanced fa t-suppressed imaging and .72 for conventional contrast-enhanced imagin g. CONCLUSION. Contrast-enhanced fat-suppressed T1-weighted spin-echo MR imaging is a valuable technique for visualizing the extent and degr ee of lesions in the posterior disk attachment and bone marrow lesions in the mandibular condyle.