Clinical Diagnostic Imaging Study of Osteoradionecrosis of the Jaw: A Retrospective Study

Journal of Clinical Medicine

Mitsuru Izumisawa¹  Noriaki Takahashi¹  Ryoichi Tanaka¹  Genki Yamaya²  Tadashi Kawai²  Shintaro Kogi²  Hiroyuki Yamada²  Yu Ohashi²  Ikuya Miyamoto² 

[1] Division of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan;Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan;

关键词: osteoradionecrosis;    trismus;    computed tomography;    magnetic resonance imaging;    positron emission tomography;    single-photon emission computed tomography;   

DOI  :  10.3390/jcm10204704

来源: DOAJ

【 摘 要 】

Radiation therapy (RT) plays a significant role in the management of head and neck malignancies. This study aimed to review the clinical symptoms and various imaging findings of osteoradionecrosis (ORN) and provide a clinical perspective on the development of ORN. The retrospective cohort was composed of 57 sites in 54 patients who had a history of RT and suspected ORN and 48 sites in 45 patients who were confirmed to have ORN. Image analyses included computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, bone scintigraphy, and single-photon emission CT (SPECT). The irradiated tissue was damaged by RT, and the extent of damage was correlated with clinical symptoms. The bone marrow showed sclerotic changes and the devitalized bone showed bone resorption after invasive stimulation. Chronic trismus and pathological fracture are considered severe conditions, typically occurring in the last stage of ORN. Furthermore, neurological symptoms were an important sign of tumor recurrence, since diagnostic imaging was difficult. The possible treatment options vary depending on the stage of ORN. We speculate that bone sclerosis reactions and bone resorption are sequential reactions that seem to be protective measures of the bone to radiation injury.

【 授权许可】

Unknown