Tc-99m hydroxymethylene diphosphonate scintigraphy, computed tomography, and magnetic resonance imaging of osteonecrosis in the mandible: Osteoradionecrosis versus medication-related osteonecrosis of the jaw
Ogura Ichiro, Sasaki Yoshihiko, Sue Mikiko, Oda Takaaki, Kameta Ayako, Hayama Kazuhide,
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( Ogura Ichiro ) - Nippon Dental University School of Life Dentistry at Niigata Department of Oral and Maxillofacial Radiology
( Sasaki Yoshihiko ) - Nippon Dental University Niigata Hospital Department of Radiology
( Sue Mikiko ) - Nippon Dental University Niigata Hospital Department of Radiology
( Oda Takaaki ) - Nippon Dental University Niigata Hospital Department of Radiology
( Kameta Ayako ) - Nippon Dental University School of Life Dentistry at Niigata Department of Oral and Maxillofacial Radiology
( Hayama Kazuhide ) - Nippon Dental University School of Life Dentistry at Niigata Department of Oral and Maxillofacial Radiology
Abstract
Purpose: To present characteristic findings of Tc-99m hydroxymethylene diphosphonate (HMDP) scintigraphy, computed tomography (CT), and magnetic resonance (MR) imaging for osteonecrosis in the mandible, especially osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ).
Materials and Methods: Thirteen patients with MRONJ and 7 patients with ORN in the mandible underwent Tc-99m HMDP scintigraphy, CT, and MR imaging (T1-weighted images [T1WI], T2-weighted images [T2WI], short inversion time inversion recovery images [STIR]), diffusion-weighted images [DWI], and apparent diffusion coefficient [ADC] mapping). The associations of scintigraphy, CT, and MR imaging findings with MRONJ and ORN were analyzed using the chi-square test with the Pearson exact test.
Results: Thirteen patients with MRONJ and 7 patients with ORN in the mandible showed low signal intensity on T1WI and ADC mapping, high signal intensity on STIR and DWI, and increased uptake on scintigraphy. Periosteal bone proliferation on CT was observed in 69.2% of patients with MRONJ (9 of 13) versus 14.3% of patients with ORN (1 of 7) (P=0.019).
Conclusion: This study presented characteristic imaging findings of MRONJ and ORN on scintigraphy, CT, and MR imaging. Our results suggest that CT can be effective for detecting MRONJ and ORN.
키워드
Osteonecrosis; Tomography, X-Ray Computed; Radionuclide Imaging; Magnetic Resonance Imaging
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