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Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders.

Lopes SL, Costa AL, Gamba Tde O, Flores IL, Cruz AD, Min LL - Imaging Sci Dent (2015)

Bottom Line: MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter.In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine.LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnosis and Surgery, São José dos Campos Dental School, UNESP, São Paulo, Brazil.

ABSTRACT

Purpose: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ.

Materials and methods: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache.

Results: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine.

Conclusion: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

No MeSH data available.


Related in: MedlinePlus

Three-dimensional model of the segmented structures using the ITK-SNAP software in an anterior superior view shows the lateral pterygoid muscle (a, b), the condyle, the coronoid process of the mandible, and part of the mandibular ramus (R).
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Figure 1: Three-dimensional model of the segmented structures using the ITK-SNAP software in an anterior superior view shows the lateral pterygoid muscle (a, b), the condyle, the coronoid process of the mandible, and part of the mandibular ramus (R).

Mentions: All the closed-mouth images were recorded in the Digital Imaging and Communications in Medicine format and then converted to the Analyze (Mayo Clinic, Rochester, USA) format using the MRIcro software (www.mccauslandcenter.sc.edu, MacCausland Center for Brain Imaging, Columbia, SC, USA). The Analyze format is required for processing and image fusion programs. The DICOM format contains text information about the patient, while the Analyze format only contains the raw image. All the Analyze images were exported into the ITK-SNAP 1.4.1 software (University of North Carolina, Chapel Hill, NC), which calculates the volume of each segmented structure in voxels per cubic millmeter.11 In this study, the images of the muscles in each corresponding slice were segmented in the axial, sagittal, and coronal planes to obtain the LPM volume of each TMJ. The right and left LPMs were segmented individually, using different labels and colors (red for the right and dark pink for the left), in order to obtain the volume for each LPM. The condyle, coronoid process, and part of the ramus of the mandible (labeled in light blue) were also segmented, in order to provide orientation landmarks in the three-dimensional models (Fig. 1).


Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders.

Lopes SL, Costa AL, Gamba Tde O, Flores IL, Cruz AD, Min LL - Imaging Sci Dent (2015)

Three-dimensional model of the segmented structures using the ITK-SNAP software in an anterior superior view shows the lateral pterygoid muscle (a, b), the condyle, the coronoid process of the mandible, and part of the mandibular ramus (R).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4362986&req=5

Figure 1: Three-dimensional model of the segmented structures using the ITK-SNAP software in an anterior superior view shows the lateral pterygoid muscle (a, b), the condyle, the coronoid process of the mandible, and part of the mandibular ramus (R).
Mentions: All the closed-mouth images were recorded in the Digital Imaging and Communications in Medicine format and then converted to the Analyze (Mayo Clinic, Rochester, USA) format using the MRIcro software (www.mccauslandcenter.sc.edu, MacCausland Center for Brain Imaging, Columbia, SC, USA). The Analyze format is required for processing and image fusion programs. The DICOM format contains text information about the patient, while the Analyze format only contains the raw image. All the Analyze images were exported into the ITK-SNAP 1.4.1 software (University of North Carolina, Chapel Hill, NC), which calculates the volume of each segmented structure in voxels per cubic millmeter.11 In this study, the images of the muscles in each corresponding slice were segmented in the axial, sagittal, and coronal planes to obtain the LPM volume of each TMJ. The right and left LPMs were segmented individually, using different labels and colors (red for the right and dark pink for the left), in order to obtain the volume for each LPM. The condyle, coronoid process, and part of the ramus of the mandible (labeled in light blue) were also segmented, in order to provide orientation landmarks in the three-dimensional models (Fig. 1).

Bottom Line: MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter.In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine.LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnosis and Surgery, São José dos Campos Dental School, UNESP, São Paulo, Brazil.

ABSTRACT

Purpose: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ.

Materials and methods: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache.

Results: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine.

Conclusion: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

No MeSH data available.


Related in: MedlinePlus