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• Clinical Article •
The diagnostic value of radiomics features of the lateral pterygoid muscle, articular disc, and bilaminar zone on MRI in temporomandibular disorders
SUN Siqi  LIU Mengqiu  ZHAO Jiajia  JIANG Pan  GUAN Ruirui  LIU Ying 

DOI:10.12015/issn.1674-8034.2026.01.015.


[Abstract] Objective To investigate the radiomic features of the lateral pterygoid muscle, articular disc, and bilaminar zone (retrodiscal tissue) on magnetic resonance imaging (MRI) in patients with temporomandibular disorder (TMD). The study aims to facilitate the early diagnosis and differential diagnosis of TMD subtypes, thereby enhancing clinical efficiency.Materials and Methods This retrospective study included imaging and clinical data from patients clinically diagnosed with TMD at the First Affiliated Hospital of University of Science and Technology of China between December 2019 and October 2024. A total of 121 patients were enrolled. Data from each joint side were analyzed independently, resulting in three groups: 33 sides with reducible disc displacement (RDD), 89 sides with non-reducible disc displacement (NRDD), and 120 sides without disc displacement (ND). Radiomic features were extracted from the lateral pterygoid muscle, articular disc, and bilaminar zone. Univariate analysis of variance (ANOVA) with Bonferroni correction was employed to identify features with significant differences among the three groups. Subsequently, a "One-vs-Rest" (OVR) strategy was used to train logistic regression models, with the selected significant features as inputs and the predicted probabilities for each group as outputs. Three predictive models were developed: a clinical model, a radiomics model, and a combined model (integrating both clinical and radiomic features), using univariate and multivariate logistic regression analyses. The training set was partitioned using stratified random sampling, and the diagnostic performance was evaluated on the testing set. After performing stratified 5-fold cross-validation, the model performance was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. The DeLong test was used to assess the statistical significance of differences between AUCs, and decision curve analysis (DCA) was conducted to evaluate the predictive net benefit of the models.Results (1) Seven radiomic features from the bilaminar zone and five from the articular disc were identified as significantly different among the three groups. No significant features were found in the lateral pterygoid muscle, suggesting limited radiomic differences in this muscle across TMD subtypes. (2) The ROC curve analysis demonstrated that the significant features from the articular disc achieved high diagnostic performance in distinguishing between NRDD (AUC = 0.79) and ND (AUC = 0.78). The significant features from the bilaminar zone showed high efficacy in identifying ND (AUC = 0.84). (3) All statistical tests were two-sided, with the significance level set at 0.05. Evaluation on the testing set revealed that the combined model (AUC = 0.90) exhibited significantly stronger and more stable discriminatory power, as well as superior predictive and diagnostic efficacy, compared to the clinical model (AUC = 0.88) and the radiomics model (AUC = 0.78).Conclusions While radiomic analysis of the lateral pterygoid muscle alone is insufficient for TMD subtype differentiation, our study establishes that MRI-based radiomics of the articular disc and bilaminar zone provides a novel paradigm for early diagnosis, differential diagnosis, and guiding clinical interventions in TMD.
[Keywords] temporomandibular joint disorders；bilaminar zone；articular disc；lateral pterygoid muscle；magnetic resonance imaging；radiomics

SUN Siqi   LIU Mengqiu   ZHAO Jiajia   JIANG Pan   GUAN Ruirui   LIU Ying*  

First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, China

Corresponding author: LIU Y, E-mail: felice828@126.com

Conflicts of interest   None.

Received  2025-07-30
Accepted  2025-12-19
DOI: 10.12015/issn.1674-8034.2026.01.015
DOI:10.12015/issn.1674-8034.2026.01.015.

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