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Oral Radiology
Published in: Oral Radiology 1/2018

01-01-2018 | Original Article

Evaluation of lateral pterygoid muscles in painful temporomandibular joints by signal intensity on fluid-attenuated inversion recovery images

Authors: Migiwa Kuroda, Mika Otonari-Yamamoto, Kazuyuki Araki

Published in: Oral Radiology | Issue 1/2018

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Abstract

Objectives

Pathological changes of the lateral pterygoid muscle (LPM) have been investigated using various modalities, including magnetic resonance (MR) imaging and electromyography. Fluid-attenuated inversion recovery (FLAIR) is an MR sequence that we hypothesized can be used to evaluate abnormalities of the LPM. The purpose of this study was to analyze the FLAIR signal intensity of the LPM in painful temporomandibular joints (TMJs) and investigate the pathological changes of the muscle.

Methods

The study was based on 149 TMJs of 77 patients who were referred for MR imaging of the TMJ. Patients rated their degree of pain during chewing and mouth opening using a visual analog scale (VAS). Regions of interest were placed over the superior and inferior heads of the LPM and gray matter on FLAIR sagittal images. Using the signal intensity of gray matter as a reference, the signal intensity ratio (SIR) of the LPM was calculated. Spearman’s rank-correlation coefficient was used to analyze the correlation between the SIR and the VAS score (p < 0.05).

Results

A significant correlation was present between the SIR on FLAIR images and the VAS score.

Conclusions

These results suggest that the FLAIR signal intensity of the superior and inferior heads of the LPM significantly increases as TMJ pain becomes more severe. Thus, FLAIR could be useful in assessing the relationship between the MR signals of the LPM and clinical symptoms.
Literature
1.
Murray GM, Bhutada M, Peck CC, Phanachet I, Sae-Lee D, Whittle T. The human lateral pterygoid muscle. Arch Oral Biol. 2007;52:377–80.CrossRefPubMed
2.
Lopes SL, Costa AL, Gamba Tde O, Flores IL, Cruz AD, Min LL. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders. Imaging Sci Dent. 2015;45:1–5.CrossRefPubMedPubMedCentral
3.
Awan KH, Patil S. The role of transcutaneous electrical nerve stimulation in the management of temporomandibular joint disorder. J Contemp Dent Pract. 2015;16:984–6.CrossRefPubMed
4.
Hiraba K, Hibino K, Hiranuma K, Negoro T. EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force. J Neurophysiol. 2000;83:2120–37.CrossRefPubMed
5.
Fujita S, Iizuka T, Dauber W. Variation of heads of lateral pterygoid muscle and morphology of articular disc of human temporomandibular joint–anatomical and histological analysis. J Oral Rehabil. 2001;28:560–71.CrossRefPubMed
6.
D’Ippolito SM, Borri Wolosker AM, D’Ippolito G, Herbert de Souza B, Fenyo-Pereira M. Evaluation of the lateral pterygoid muscle using magnetic resonance imaging. Dentomaxillofac Radiol. 2010;39:494–500.CrossRefPubMedPubMedCentral
7.
Yang X, Pernu H, Pyhtinen J, Tiilikainen PA, Oikarinen KS, Raustia AM. MR abnormalities of the lateral pterygoid muscle in patients with nonreducing disk displacement of the TMJ. Cranio. 2002;20:209–21.CrossRefPubMed
8.
Taskaya-Yilmaz N, Ceylan G, Incesu L, Muglali M. A possible etiology of the internal derangement of the temporomandibular joint based on the MRI observations of the lateral pterygoid muscle. Surg Radiol Anat. 2005;27:19–24.CrossRefPubMed
9.
Omami G, Lurie A. Magnetic resonance imaging evaluation of discal attachment of superior head of lateral pterygoid muscle in individuals with symptomatic temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:650–7.CrossRefPubMed
10.
Imanimoghaddam M, Madani AS, Hashemi EM. The evaluation of lateral pterygoid muscle pathologic changes and insertion patterns in temporomandibular joints with or without disc displacement using magnetic resonance imaging. Int J Oral Maxillofac Surg. 2013;42:1116–20.CrossRefPubMed
11.
Coene BD, Hajnal JV, Pennock JM, Bydder GM. MRI of the brain stem using fluid attenuated inversion recovery pulse sequences. Neuroradiology. 1993;35:327–31.CrossRefPubMed
12.
Hajnal JV, Bryant DJ, Kasuboski L, Pattany PM, De Coene B, Lewis PD, et al. Use of fluid attenuated inversion recovery (FLAIR) pulse sequences in MRI of the brain. J Comput Assist Tomogr. 1992;16:841–4.CrossRefPubMed
13.
Imoto K, Otonari-Yamamoto M, Nishikawa K, Sano T, Yamamoto A. Potential of fluid-attenuated inversion recovery (FLAIR) in identification of temporomandibular joint effusion compared with T2-weighted images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:243–8.CrossRefPubMed
14.
Hanyuda H, Otonari-Yamamoto M, Imoto K, Sakamoto J, Kodama S, Kamio T, et al. Analysis of elements in a minimal amount of temporomandibular joint fluid on fluid-attenuated inversion recovery magnetic resonance images. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115:114–20.CrossRefPubMed
15.
Kodama S, Otonari-Yamamoto M, Sano T, Sakamoto J, Imoto K, Wakoh M. Signal intensity on fluid-attenuated inversion recovery images of condylar marrow changes correspond with slight pain in patients with temporomandibular joint disorders. Oral Radiol. 2014;30:212–8.CrossRefPubMedPubMedCentral
16.
Kuroda M, Otonari-Yamamoto M, Sano T, Fujikura M, Wakoh M. Diagnosis of retrodiscal tissue in painful temporomandibular joint (TMJ) by fluid-attenuated inversion recovery (FLAIR) signal intensity. Cranio. 2015;33:271–5.CrossRefPubMed
17.
Yamamoto A, Sano T, Otonari-Yamamoto M, Nishikawa K, Kwok E. A potential reference point for assessment of condylar bone marrow of the temporomandibular joint on proton density weighted images. Cranio. 2008;26:246–52.CrossRefPubMed
18.
Yajima A, Sano T, Otonari-Yamamoto M, Otonari T, Ohkubo M, Harada T, et al. MR evidence of characteristics in symptomatic osteoarthritis of the temporomandibular joint: increased signal intensity ratio on proton density-weighted images of bone marrow in the mandibular condyle. Cranio. 2007;25:250–6.CrossRefPubMed
19.
Conti PC, Costa YM, Gonçalves DA, Svensson P. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements? J Oral Rehabil. 2016;43(9):702–15.CrossRefPubMed
20.
Yap AUJ, Ho VCL. Temporomandibular disorders—an overview. Singapore Med J. 1999;40:179–82.PubMed
21.
Murray GM, Phanachet I, Uchida S, Whittle T. The human lateral pterygoid muscle: a review of some experimental aspects and possible clinical relevance. Aust Dent J. 2004;49:2–8.CrossRefPubMed
22.
Bravetti P, Membre H, El Haddioui A, Gérard H, Fyard JP, Mahler P, et al. Histological study of the human temporo-mandibular joint and its surrounding muscles. Surg Radiol Anat. 2004;26:371–8.CrossRefPubMed
23.
El Haddioui A, Laison F, Zouaoui A, Bravetti P, Gaudy JF. Functional anatomy of the human lateral pterygoid muscle. Surg Radiol Anat. 2005;27:271–86.CrossRefPubMed
24.
Usui A, Akita K, Yamaguchi K. An anatomic study of the divisions of the lateral pterygoid muscle based on the findings of the origins and insertions. Surg Radiol Anat. 2008;30:327–33.CrossRefPubMed
25.
Davies JC, Charles M, Cantelmi D, Liebgott B, Ravichandiran M, Ravichandiran K, et al. Lateral pterygoid muscle: a three-dimensional analysis of neuromuscular partitioning. Clin Anat. 2012;25:576–83.CrossRefPubMed
26.
Nikkuni Y, Nishiyama H, Hayashi T. Clinical significance of T2 mapping MRI for the evaluation of masseter muscle pain in patients with temporomandibular joint disorders. Oral Radiol. 2013;29:50–5.CrossRef
27.
Ariji Y, Sakuma S, Izumi M, Sasaki J, Kurita K, Ogi N, et al. Ultrasonographic features of the masseter muscle in female patients with temporomandibular disorder associated with myofascial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:337–41.CrossRefPubMed
28.
Nagayama K, Suenaga S, Nagata J, Takada H, Majima HJ, Miyawaki S. Clinical significance of magnetization transfer contrast imaging for edematous changes in masticatory muscle. J Comput Assist Tomogr. 2010;34:233–41.CrossRefPubMed
29.
Ariji Y, Kimura Y, Gotoh Y, Sakuma S, Zhao Y, Ariji E. Blood flow in and around the masseter muscle: normal and pathologic features demonstrated by color Doppler sonography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:472–82.CrossRefPubMed
30.
Castrillon EE, Cairns BE, Ernberg M, Wang K, Sessle B, Svensson P, et al. Glutamate-evoked jaw muscle pain as a model of persistent myofascial TMD pain. Arch Oral Biol. 2008;53:666–76.CrossRefPubMedPubMedCentral
31.
Cairns BE, Gambarota G, Svensson P, Arendt-Nielsen L, Berde CB. Glutamate-induced sensitization of rat masseter muscle fibers. Neuroscience. 2002;109:389–99.CrossRefPubMed
32.
Kodama J. Morphological study of human pterygoid plexus. J Fukuoka Dent Coll. 2000;27:83–95.
33.
Momose T, Nishikawa J, Watanabe T, Sasaki Y, Senda M, Kubota K, et al. Effect of mastication on regional cerebral blood flow in humans examined by positron-emission tomography with 15O-labelled water and magnetic resonance imaging. Arch Oral Biol. 1997;42:57–61.CrossRefPubMed
34.
Katayama T. Determination of the route of vein circulation by the human pterygoid plexus. J Fukuoka Dent Coll. 2002;28:103–14.
35.
Mishra AM, Reddy SJ, Husain M, Behari S, Husain N, Prasad KN, et al. Comparison of the magnetization transfer ratio and fluid-attenuated inversion recovery imaging signal intensity in differentiation of various cystic intracranial mass lesions and its correlation with biological parameters. J Magn Reson Imaging. 2006;24:52–6.CrossRefPubMed
36.
Melhem ER, Jara H, Eustace S. Fluid-attenuated inversion recovery MR imaging: identification of protein concentration threshold for CSF hyperintensity. AJR Am J Roentgenol. 1997;169:859–62.CrossRefPubMed
37.
Larheim TA, Westesson PL, Hicks DG, Eriksson L, Brown DA. Osteonecrosis of the temporomandibular joint: correlation of magnetic resonance imaging and histology. J Oral Maxillofac Surg. 1999;57:888–98.CrossRefPubMed
38.
Mahan PE, Wilkinson TM, Gibbs CH, Mauderli A, Brannon LS. Superior and inferior bellies of the lateral pterygoid muscle EMG activity at basic jaw positions. J Prosthet Dent. 1983;50:710–8.CrossRefPubMed
Metadata
Title
Evaluation of lateral pterygoid muscles in painful temporomandibular joints by signal intensity on fluid-attenuated inversion recovery images
Authors
Migiwa Kuroda
Mika Otonari-Yamamoto
Kazuyuki Araki
Publication date
01-01-2018
Publisher
Springer Singapore
Published in
Oral Radiology / Issue 1/2018
Print ISSN: 0911-6028
Electronic ISSN: 1613-9674
DOI
https://doi.org/10.1007/s11282-017-0272-1

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