Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology
Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology
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DOI：
10.1016/j.tripleo.2007.08.040
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发表时间：
2008-03-01
期刊：
影响因子：
--
通讯作者：
Nocini, Pier Francesco
中科院分区：
文献类型：
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作者：
Bedogni, Alberto;Blandamura, Stella;Nocini, Pier Francesco
目标。最近，有报道称颌骨骨坏死是双膦酸盐给药的潜在副作用。本文考虑并强调了这种情况的组织病理学和放射学特征。研究设计。 11名患者由于对保守治疗无反应且无法控制的疼痛，在广泛的高压氧治疗后接受了患病颌骨的手术切除。进行了彻底的临床、实验室和影像学研究。对手术标本进行组织病理学和免疫组织化学评估。结果。计算机断层扫描 (CT) 扫描显示骨密度增加、骨膜反应和晚期骨隔离。通过磁共振成像 (MRI)，暴露区域在 T1 和 T2 加权以及反转恢复图像中显示出低信号，这表明含水量较低，并且在组织病理学上与细胞和血管的缺乏（骨坏死模式）相关。未暴露的患病骨的特征是T1低信号和T2和IR高信号，这表明高含水量和炎症，与细胞增多、成骨和血管增多（骨髓炎模式）相关。结论。患病的骨头超出了口腔中暴露的骨头的范围。组织病理学检查与 CT 和 MRI 相关性良好，是评估双膦酸盐相关颌骨骨坏死的选择。
Objectives. Recently, jawbone osteonecrosis has been reported as a potential adverse effect of bisphosphonates administration. This paper considers and highlights histopathologic and radiologic features of this condition.Study design. Eleven patients, owing to unresponsiveness to conservative treatment and uncontrollable pain, underwent surgical resection of diseased jawbone after extensive hyperbaric oxygen therapy. A thorough clinical, laboratory, and imaging study was performed. Surgical specimens underwent histopathologic and immunohistochemical evaluation.Results. Computerized tomography (CT) scans showed increased bone density, periosteal reaction, and bone sequestration in advanced stages. With magnetic resonance imaging (MRI), exposed areas showed a low signal in T1-and T2-weighted and inversion recovery images, which suggests low water content and is histopathologically correlated with paucity in cells and vessels (osteonecrotic pattern). Unexposed diseased bone was characterized by T1 hypointensity and T2 and IR hyperintensity, which suggests high water content and inflammation, associated with hypercellularity, osteogenesis, and hypervascularity (osteomyelitic pattern).Conclusions. Diseased bone extends beyond the limits of the bone exposed in the oral cavity. Histopathologic examination correlated well with CT and MRI, which are the choice for the evaluation of bisphosphonate-associated jawbone osteonecrosis.