3D-visualization of the temporomandibular joint with focus on the articular disc based on clinical T1-, T2-, and proton density weighted MR images

Objective An approach of 3D-visualization of the temporomandibular joint (TMJ) with special focus on the articular disc based on magnetic resonance imaging (MRI) was developed for the purpose of diagnosis support. Materials and methods Mandibular condyle and fossa were reconstructed as 3D-surfaces. Articular disc, retrocondylar tissue, and the lateral pterygoid muscle were visualized by means of direct volume rendering. By simultaneous visualization of both, the bony surfaces and the soft tissue, anterior disc displacement could be recognized in 3D-context. Additional superposition of the 3D-visualization with the original 2D-MRI slices allowed for a combination with conventional diagnostics. The method was tested for clinical T1-, T2-, and proton density weighted MRI data from four independent medical institutions. Results For all cases, the skeletal anatomy could be reproduced. Applied validation approaches showed good results. Anterior disc displacement could be clearly depicted as well as the incidence of reduction of the disc. By several experienced observers, the approach was rated as significant. Conclusion Although partially non-standard in the clinical routine the new method provided promising results for efficient diagnosis support. Its validity in the medical practice, namely, its impact for dislocation/deformity of the mandibular disc will be further analyzed.