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Campinhos MLB, Curioni OA, Soares AH, Marcucci M. Computed tomography evaluation of alterations in the masticator space due to invasion by malignant head and neck neoplasms. Radiol Bras 2023; 56:275-281. [PMID: 38204895 PMCID: PMC10775806 DOI: 10.1590/0100-3984.2023.0024-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/28/2023] [Accepted: 07/06/2023] [Indexed: 01/12/2024] Open
Abstract
Objective To evaluate alterations in the masticator space due to the dissemination of malignant neoplasms originating from the tonsillar fossa, retromolar trigone, maxillary sinus, or nasopharynx, using computed tomography (CT), as well as to correlate the presence of trismus with the CT findings and the dimensions of the tumor. Materials and Methods We evaluated the medical records of 65 patients with malignant tumors in the regions described. The images were analyzed by two physician examiners, working independently, who were blinded to the clinical data. In the evaluation of the masticator space, the following parameters were considered: symmetry with the contralateral space; obliteration of the fat plane, retromolar trigone, or pharyngeal space; edema/atrophy of the medial or lateral pterygoid muscles; and destruction of the mandibular ramus. Results Obliteration of the fat plane was found in 69.2% of the patients. Asymmetry, edema/atrophy, and bone destruction were detected in 27.7%, 26.2%, and 20.0% of the patients, respectively. Trismus was identified in 15.4% of the patients. Of the patients with trismus, 90.0% had stage T4 tumors, compared with only 43.8% of those without trismus. Trismus was 11.6 times more common among the patients with stage T4 tumors than among those with lower-stage tumors. Neoplasms of the tonsillar fossa and retromolar trigone collectively accounted for 95.0% of the cases. The CT scans showed edema/atrophy of the pterygoid muscles in 60.0% of the patients with trismus and in 21.8% of those without. An association was observed between T4 tumor stage and edema/atrophy of the pterygoid muscles. In addition, the risk of trismus was 5.4 times higher among the patients with stage T4 tumors. Conclusion In our patient sample, the most common finding was obliteration of the fat plane, followed by asymmetry and edema/atrophy. Most of the patients with T4 tumors had trismus, together with edema/atrophy of the pterygoid muscles.
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Shimamoto H, Majima M, Kitamori H, Tsujimoto T, Kakimoto N, Iwamoto Y, Senda Y, Kreiborg S, Mallya SM, Murakami S. Diffusion-weighted magnetic resonance imaging of the oral and maxillofacial region: optimal fat suppression method. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:S2212-4403(20)31236-0. [PMID: 34756417 DOI: 10.1016/j.oooo.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/10/2020] [Accepted: 09/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare 3 fat suppression methods-water excitation (WE), chemical shift selective (CHESS), and short T1 inversion recovery (STIR)-for optimal image quality and apparent diffusion coefficient (ADC) values with magnetic resonance imaging (MRI) using diffusion-weighted imaging (DWI) of the oral and maxillofacial region. STUDY DESIGN In total, 53 patients with 73 lesions were enrolled in this study. MRI using DWI protocols with the 3 fat suppression methods were performed in addition to a conventional MRI protocol. The diagnostic image quality of lesions, image uniformity, degree of image artifacts, and ADC values of the lesions were evaluated. Average visual scores and ADC values were compared, and post hoc pairwise comparisons were performed, with the level of significance set at P < .0167. RESULTS Diagnostic image quality was not significantly different among the fat suppression methods (P ≥ .042). Image uniformity was significantly higher (P < .001), and the degree of image artifacts was significantly lower (P < .001), in images using the STIR method. Mean ADC values did not differ significantly among the 3 methods. CONCLUSIONS The STIR method was the most useful fat suppression method for DWI of the oral and maxillofacial region because of its high level of image uniformity and few image artifacts.
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Affiliation(s)
- Hiroaki Shimamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan.
| | - Minami Majima
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hideki Kitamori
- Department of Oral and Maxillofacial Radiology, Osaka University Dental Hospital, Osaka, Japan
| | - Tomomi Tsujimoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuri Iwamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yurie Senda
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Sven Kreiborg
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen; Centre of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet; and Department of Applied Mathematics and Computer Science, Technical University of Denmark), Copenhagen, Denmark
| | - Sanjay M Mallya
- Section of Oral and Maxillofacial Radiology, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Munhoz L, Nishimura DA, Hisatomi M, Yanagi Y, Asaumi J, Arita ES. Application of diffusion-weighted magnetic resonance imaging in the diagnosis of odontogenic lesions: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 130:85-100.e1. [PMID: 32007494 DOI: 10.1016/j.oooo.2019.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This systematic literature review addresses the use of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) for the evaluation of benign maxillomandibular odontogenic lesions. STUDY DESIGN Databases were searched, and original research studies or case report manuscripts up to April 2019 were included, using the keyword "diffusion," combined with the keywords "maxillofacial pathology," "oral pathology," "odontogenic tumors," "dental tissue neoplasms," "odontogenic cysts," and the histologic denomination of benign odontogenic lesions, according to the World Health Organization classification. Only English language articles and studies pertaining to DWI were selected. RESULTS Fifteen investigations (11 original articles and 4 case reports) of distinct benign odontogenic lesions were included. Most studies did not include exclusively odontogenic lesions in their samples. CONCLUSIONS It is too early to reach a conclusion that DWI and ADC can provide useful information in the differentiation of the histologic type of some benign odontogenic lesions on the basis of available data in the literature.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil.
| | | | - Miki Hisatomi
- Department of Dentomaxillofacial Radiology and Oral Diagnosis, Okayama University Hospital, Okayama, Japan
| | - Yoshinobu Yanagi
- Department of Dentomaxillofacial Radiology and Oral Diagnosis, Okayama University Hospital, Okayama, Japan
| | - Junich Asaumi
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
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Oki S, Kawabori M, Motegi H, Yamaguchi S, Kobayashi H, Terasaka S, Houkin K. A Rare Case of Idiopathic Temporal Muscle Abscess in a Nine-month-old Infant. Intern Med 2019; 58:2699-2702. [PMID: 31178474 PMCID: PMC6794185 DOI: 10.2169/internalmedicine.2727-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Temporal muscle abscess in children usually occurs from acute otitis media, and rapid progression and concomitant infectious disease often make it easy to diagnose. We report a rare case of a nine-month-old infant who showed right temporal mass with no evidence of infection. Computed tomography showed an osteolytic round mass, and magnetic resonance imaging revealed heterogenous enhancement with a high apparent diffusion coefficient. Malignant tumor was first suspected, but an open biopsy revealed the swelling to be temporal muscle abscess. It should be noted that temporal abscess may mimic the features of a malignant tumor, and multiple examinations should be performed for an accurate diagnosis.
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Affiliation(s)
- Sogo Oki
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Masahito Kawabori
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Hiroaki Motegi
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Shigeru Yamaguchi
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Hiroyuki Kobayashi
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Shunsuke Terasaka
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Kiyohiro Houkin
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
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Zhang D, Li X, Xiong H, Yang C, Lv F, Huang X, Li Q, Tang Z, Luo T. Tuberculosis of the parotid lymph nodes: clinical and imaging features. Infect Drug Resist 2018; 11:1795-1805. [PMID: 30349336 PMCID: PMC6188200 DOI: 10.2147/idr.s164993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objectives To characterize clinical, computed tomography (CT) and magnetic resonance imaging (MRI) features of tuberculosis (TB) of the parotid nodes. Materials and methods CT (n=21) and MR (n=7) images, and clinical data from 25 patients with TB of the parotid nodes were retrospectively analyzed by two experienced radiologists who reached consensus. Results Younger patients (aged <50 years) accounted for 72%. Eighty percent of patients were asymptomatic, and had no history of TB exposure. According to clinical and imaging findings, 64% and 60% patients were misdiagnosed as having tumors, respectively. A total of 43 lesions were identified. Thirty-eight (88.4%) lesions involved the superficial lobe. Fourteen (56%) cases had multiple lesions. There were four types of changes in the parotid fascia: local thickening (40%, n=10); local rupture with thickened adjacent skin (28%, n=7); focal bulge (20%, n=5); and no changes (12%, n=3). Cervical lymphadenopathy was seen in 14 out of 25 cases (56%). The lesions were contrast-enhanced in four patterns on CT images: homogeneous enhancement (37.1%, n=13), irregular cyst-like enhancement (37.1%, n=13), thick-walled ring enhancement (14.2%, n=5), and garland-like enhancement (11.4%, n=4). On MRI, the signal intensity of lesions was isointense on T1-weighted image, hyperintense on T2-weighted image, markedly hyperintense on diffusion-weighted imaging, and low on the apparent diffusion coefficient map. The surrounding parotid parenchymal edema was identified clearly on coronal MR images. Conclusion TB of the parotid nodes tend to simulate tumors clinically and radiologically. Their preferential sites are the superficial lobe. In young patients with positive purified protein derivative skin test and lesions accompanied by cervical lymphadenopathy, changes in the parotid fascia and parotid parenchymal edema adjacent to the lesions on CT and MRI may be helpful in the diagnosis and to facilitate differential diagnosis.
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Affiliation(s)
- Dan Zhang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China, .,Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China,
| | - Xiaojiao Li
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China, .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China,
| | - Hua Xiong
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China, .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China,
| | - Chao Yang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China, .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China,
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China,
| | - Xianlong Huang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China, .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China,
| | - Qi Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China,
| | - Zhuoyue Tang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China, .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China,
| | - Tianyou Luo
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China,
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Yu S, Zhang Z, Bao Q, Su J, Liu M, Shi Q, Cai W. Diffusion kurtosis imaging in the differential diagnosis of parotid gland disease and parotid adenolymphoma: preliminary results. Dentomaxillofac Radiol 2018; 47:20170388. [PMID: 29676939 DOI: 10.1259/dmfr.20170388] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To study the value of diffusion kurtosis imaging (DKI) in diagnosis of parotid gland disease (PGD) with different pathological patterns and parotid adenolymphoma (PAL). METHODS 57 patients with different kinds of PGD were enrolled and underwent DKI and conventional diffusion-weighted imaging (DWI). All patients were categorized into different groups according to their pathological patterns. The result of calculating the value of DKI-derived parameters (Kmean, Krad, Kax, Dmean, Drad, Dax, and FA) and apparent diffusion coefficient (ADC) of DWI were used to study their diagnostic accuracy in PGD with different pathological patterns. The binary logistic regression method was used to confirm clinical valuable diffusion parameters (obtained with DKI and DWI models) for diagnosing PAL. Using MedCalc 13.0, receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic value of confirmed parameters based on the logistic regression equation. RESULTS Both DKI parameters and conventional ADC showed statistical significance in diagnosing PGD with different pathological patterns (p < .01). By using the DKI model, kurtosis coefficients showed higher diagnostic capability than diffusion coefficients ([Kmean+Krad + Kax] vs [Dmean +Drad + Dax]: 22 vs 15, p < .01) did in the differential diagnosis among different PGD groups. In the diagnosis of PAL among all PGD patterns, the ROC analysis demonstrated that the area under curve (AUC) FA +Kax [0.881 ± 0.057 (0.824 to 0.938)] is higher than that when using FA [0.629 ± 0.095 (0.534 to 0.724)] and Kax [0.800 ± 0.070 (0.730 to 0.870)] alone (p < .05), with sensitivity, specificity, accuracy, and both positive and negative predictive values of 71.43, 95.78, 91.77, 76.92, and 94.44%, respectively. CONCLUSIONS DKI showed higher diagnostic capacity in the differential diagnosis of PGD with different pathological patterns. Combined parameters of DKI can differentiate PAL from other PGD pathological patterns with a high degree of accuracy. This technique shows great potential for DKI in the differential diagnosis of PGD within a certain pathological category.
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Affiliation(s)
- Shun Yu
- 1 Department of Radiology, Provincial Clinical College of Fujian Medical University, Fujian Provincial Hospital , Fuzhou, Fujian , China
| | | | - Qiang Bao
- 1 Department of Radiology, Provincial Clinical College of Fujian Medical University, Fujian Provincial Hospital , Fuzhou, Fujian , China
| | - Jiawei Su
- 1 Department of Radiology, Provincial Clinical College of Fujian Medical University, Fujian Provincial Hospital , Fuzhou, Fujian , China
| | - Mengxiao Liu
- 2 Diagnosis Imaging, Siemens Healthcare Ltd. , Shanghai , China
| | - Qinglei Shi
- 2 Diagnosis Imaging, Siemens Healthcare Ltd. , Shanghai , China
| | - Wenchao Cai
- 1 Department of Radiology, Provincial Clinical College of Fujian Medical University, Fujian Provincial Hospital , Fuzhou, Fujian , China
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Tao X, Yang G, Wang P, Wu Y, Zhu W, Shi H, Gong X, Gao W, Yu Q. The value of combining conventional, diffusion-weighted and dynamic contrast-enhanced MR imaging for the diagnosis of parotid gland tumours. Dentomaxillofac Radiol 2017; 46:20160434. [PMID: 28299943 DOI: 10.1259/dmfr.20160434] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the value of combining conventional MRI, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI in diagnosing solid neoplasms in the parotid gland. METHODS A total of 148 subjects (101 subjects with benign and 47 subjects with malignant tumours) were evaluated with conventional MRI, DWI and DCE-MRI prior to surgery and pathologic verification. The items observed with conventional MRI included the shape, capsule and signal intensity of parotid masses. The apparent diffusion coefficient (ADC) was calculated from DWI that was obtained with a b-factor of 0 and 1000 s mm-2. A time-intensity curve (TIC) was obtained from DCE-MRI. RESULTS There were significant differences (p < 0.01) in the shape, capsule, ADC and TIC between benign and malignant parotid tumours. Irregular neoplasms without a capsule, ADC <1.12 × 10-3 mm2 s-1 and a plateau enhancement pattern were valuable parameters for predicting malignant neoplasms. A combination of all of these parameters yielded sensitivity, specificity, accuracy, positive-predictive value and negative-predictive value of 85.1%, 94.1%, 91.2%, 87.0% and 93.1%, respectively. CONCLUSIONS A combined analysis using conventional MRI, DWI and DCE-MRI is helpful in distinguishing benign from malignant tumours in the parotid gland.
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Affiliation(s)
- Xiaofeng Tao
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Gongxin Yang
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pingzhong Wang
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingwei Wu
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjing Zhu
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Huimin Shi
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Gong
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weiqing Gao
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiang Yu
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Assessment of solid lesions of the temporal fossa with diffusion-weighted magnetic resonance imaging. Int J Oral Maxillofac Surg 2015; 44:1081-5. [DOI: 10.1016/j.ijom.2015.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 04/09/2015] [Accepted: 05/15/2015] [Indexed: 12/17/2022]
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Li S, Cheng J, Zhang Y, Zhang Z. Differentiation of benign and malignant lesions of the tongue by using diffusion-weighted MRI at 3.0 T. Dentomaxillofac Radiol 2015; 44:20140325. [PMID: 25823772 DOI: 10.1259/dmfr.20140325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Diffusion-weighted MRI (DWI) has been introduced in head and neck lesions and adds important information to the findings obtained through conventional MRI. The purpose of this study was to assess the role of DWI in differentiating benign and malignant lesions of the tongue at 3.0-T field strength imaging. METHODS 78 patients with 78 lingual lesions underwent conventional MRI and DWI with b-values of 0 and 1000 s mm(-2) before therapy. The apparent diffusion coefficient (ADC) maps were reconstructed, and the ADC values of the lingual lesions were calculated and compared between benign and malignant lesions of the tongue. RESULTS The mean ADC values of the malignant tumours, benign solid lesions and cystic lesions were (1.08±0.16)×10(-3), (1.68±0.33)×10(-3) and (2.21±0.35)×10(-3) mm2 s(-1), respectively. The mean ADC values of malignant tumours were significantly lower (p<0.001) than those of benign solid lesions, and the mean ADC values of benign solid lesions were significantly lower (p<0.001) than those of cystic lesions. Receiver operating characteristic analysis showed that when an ADC value<.31×10(-3) mm2 s(-1) was used for predicting malignancy, the highest accuracy of 95.3%, sensitivity of 92.6% and specificity of 97.3% were obtained. CONCLUSIONS ADC values of benign and malignant lesions are significantly different at 3.0-T imaging. DWI can be applied as a complementary tool in the differentiation of benign and malignant lesions of the tongue.
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Affiliation(s)
- S Li
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - J Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Y Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Z Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Computed tomography and magnetic resonance imaging of lesions at masticator space. Jpn J Radiol 2014; 32:123-37. [DOI: 10.1007/s11604-014-0289-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 01/16/2014] [Indexed: 12/31/2022]
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Anatomy and pathology of the masticator space. Insights Imaging 2013; 4:605-16. [PMID: 23888350 PMCID: PMC3781239 DOI: 10.1007/s13244-013-0266-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 06/03/2013] [Accepted: 06/05/2013] [Indexed: 12/22/2022] Open
Abstract
Objective This article reviews and illustrates the anatomy and pathology of the masticator space (MS). Background Pathology of the masticator space includes inflammatory conditions, vascular lesions, and tumours. Intrinsic tumours of this space can be benign and malignant, and they may arise from the mandibular ramus, the third division of the trigeminal nerve, or the mastication muscles. Malignant tumours may appear well defined and confined by the masticator fascia, without imaging signs of aggressive extension into neighbouring soft tissues. Secondary invasion of the masticator space can also occur with tumours of the nasopharynx, oropharynx, oral cavity, and parotid glands. Perineural tumour spread (PNS), especially along the trigeminal nerve, can also occur with masticator space malignancies. Conclusion Masses of the MS are difficult to evaluate clinically, and computed tomographic (CT) and magnetic resonance (MR) images are essential for the diagnosis and characterisation of these lesions. Malignant tumours may appear well defined and confined by the fascia. Thus, when a mass is identified, a biopsy should be done promptly. PNS may occur in tumours involving the MS and its recognition on imaging studies is essential to plan the appropriate treatment. Teaching points • Differentiating between intrinsic and extrinsic lesions is essential to the differential diagnosis • Infections of the MS may cross the fascia and mimic neoplasms on imaging studies • Malignant tumours may show no aggressive signs, such as bone erosion or violation of the fascia • Perineural spread (PNS) is often clinically silent and frequently missed at imaging and leads to tumour recurrence
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Abdel Razek AAK, Nada N. Role of diffusion-weighted MRI in differentiation of masticator space malignancy from infection. Dentomaxillofac Radiol 2013; 42:20120183. [PMID: 23420858 DOI: 10.1259/dmfr.20120183] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the role of the apparent diffusion coefficient (ADC) value in differentiation of masticator space malignancy from infection. METHODS A retrospective study of 49 patients (31 male and 18 female; age range 5-66 years) with masticator space lesion was conducted. They underwent spin-echo-type echo planar diffusion-weighted MRI of the head and neck with b-values of 0 mm(2) s(-1), 500 mm(2) s(-1) and 1000 mm(2) s(-1). The ADC maps were reconstructed and the ADC value of the masticator space lesion was calculated. RESULTS The mean (± standard deviation) ADC value of masticator space malignancy (0.91 ± 0.21 × 10(-3) mm(2) s(-1)) was significantly lower (p = 0.001) than that of masticator space infection (1.59 ± 0.32 × 10(-3) mm(2) s(-1)). When an ADC value of 1.20 × 10(-3) mm(2) s(-1) was used as a threshold value for differentiating masticator space malignancy from infection, the best result was obtained with an accuracy of 88%, sensitivity of 88%, specificity of 87%, negative predictive value of 94%, positive predictive value of 86% and area under the curve of 0.92. There was a significant difference in the ADC value between squamous cell carcinoma and soft tissue sarcoma (p = 0.001), as well as between bacterial and fungal infection of the masticator space (p = 0.001). CONCLUSION We concluded that ADC value is a non-invasive promising imaging parameter that can be used for differentiation of masticator space malignancy from infection.
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Affiliation(s)
- A A K Abdel Razek
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
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Sakamoto J, Sasaki Y, Otonari-Yamamoto M, Sano T. Comparison of various methods for quantification of apparent diffusion coefficient of head and neck lesions with HASTE diffusion-weighted MR imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:266-76. [DOI: 10.1016/j.oooo.2012.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/07/2012] [Accepted: 03/12/2012] [Indexed: 01/29/2023]
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