Odontogenic infection pathway to the submandibular space: imaging assessment
Odontogenic infection pathway to the submandibular space: imaging assessment
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DOI：
10.1054/ijom.2001.0190
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发表时间：
2002-04-01
影响因子：
2.4
通讯作者：
Ariji, E
中科院分区：
文献类型：
--
作者：
Ariji, Y;Gotoh, M;Ariji, E
本研究的目的是确定牙源性感染扩散到颌下间隙的途径及其与临床症状的关系。分析了33例下颌下骨受累患者的CT和MR图像。通过筋膜间隙和组织的形状和密度的侧向不对称性以及筋膜间脂肪间隙的闭塞来评估感染的扩散。影像学表现分为三种类型：19例（57.6%），感染通过下颌舌骨肌或舌下间隙扩散（I型）。在5名患者（15.2%）中，感染通过下颌骨的骨性结构扩散，伴有骨膜反应或皮质骨板穿孔（II型），症状相对较轻。4例患者（12.1%）。感染从咀嚼间隙扩散（III型）。11例吞咽困难或发烧患者中有7例显示下颌下受累蔓延至咽旁间隙。CT和MR成像清楚地显示了牙源性感染向颌下间隙扩散的不同途径，这些途径影响了临床症状的表现。
The aims of this study were to determine the pathways of odontogenic infection spread into the submandibular space and their relationship to the clinical symptoms. Computerized tomography (CT) and magnetic resonance (MR) images of 33 patients with submandibular involvement were analyzed. The spread of infection was evaluated by lateral asymmetry of the shape and density of the fascial spaces and tissues, and by obliteration of the interfascial fat spaces. Imaging findings were classified into three types: in 19 patients (57.6%), infection spread through the mylohyoid muscle or sublingual space (type I). In five patients (15.2%), infection spread through the bony structures of the mandible with periosteal reaction or perforation of the cortical plate (type II) and was associated with relatively mild symptoms. In four patients (12.1%). infection spread from the masticatory space (type III). Seven of 11 patients with dysphagia or fever showed submandibular involvement spreading into the parapharyngeal space. CT and MR imaging clearly demonstrated different pathways of the spread of odontogenic infection into the submandibular space, which influenced the manifestation of clinical symptoms.