MRI of mandibular osteonecrosis secondary to bisphosphonates
MRI of mandibular osteonecrosis secondary to bisphosphonates
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DOI：
10.2214/ajr.07.3045
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发表时间：
2008-04-01
影响因子：
5
通讯作者：
Hervas, Vicente
中科院分区：
文献类型：
--
作者：
Garcia-Ferrer, Luis;Bagan, Jose V.;Hervas, Vicente
OBJECTIVE.双膦酸盐是一组用于治疗骨转移肿瘤患者的药物。然而，在过去的几年里，颌骨骨坏死已被报道为这种治疗的严重并发症。本研究的目的是检查MRI在评估这种疾病引起的骨病变中的应用。研究了14例接受IV双膦酸盐治疗并出现颌骨骨坏死局灶性病变的患者。这些患者由瓦伦西亚综合大学医院口腔科转诊。我们评估了T1、STIR和钆喷酸盐给药后病变的形态和行为。临床检测到26个局灶性病变，放射学检测到36个。所有临床检测到的局灶性病变在MRI上均可见。有15个局灶性病变，在临床检查中未检测到的放射学检测。在所有患者中，可以评估骨受累和骨髓、软组织、鼻窦和下颌管受累以及腺病的存在。MRI是评估颌骨骨坏死的有效工具。放射学检查可检测到但无临床相关性的局灶性病变的意义及其随时间的进展仍有待确定。
OBJECTIVE. Bisphosphonates are a group of drugs used in the treatment of oncology patients with bone metastases. However, in the past few years, osteonecrosis of the jaw has been reported as a serious complication of such treatment. The objective of this study was to examine the use of MRI in the assessment of bone lesions caused by this disease.MATERIALS AND METHODS. Fourteen patients were studied who had been treated with IV bisphosphonates and had developed focal lesions of osteonecrosis of the jaw. These patients were referred by the stomatology department of Hospital General Universitario de Valencia. We evaluated both the morphology and the behavior of the lesions in T1, STIR, and after the administration of gadolinium.RESULTS. Twenty-six focal lesions were detected clinically and 36 were detected radiologically. All the clinically detected focal lesions were visible on MRI. There were 15 focal lesions detected radiologically that were not detected on clinical examination. In all patients, it was possible to assess bone involvement and involvement of the bone marrow, soft tissues, sinuses, and mandibular canal as well as the presence of adenopathy.CONCLUSION. MRI is an effective tool in the assessment of osteonecrosis of the jaw. The significance of focal lesions detectable on radiologic examination but without clinical correlation and their progression over time remains to be determined.