Granata F, De Ponte F, Pandolfo I, Pitrone A, Vinci S, Blandino A, Longo M
Department of Radiology - University of Messina, Italy -
Interv Neuroradiol. 2007 Dec;13(4):385-8. doi: 10.1177/159101990701300410. Epub 2008 Feb 1.
We describe a rare case of mandibular highflow arteriovenous malformation (AVM) mimicking an odontogenic cyst in a young man. The diagnosis of mandibular AVM was made by CT angiography and confirmed by digital subtraction angiography. CT scan showed the extent of mandibular bone alteration and a double enlarged mandibular canal on the same side. An AVM containing a large aneurysm was demonstrated by CT angiography.The mandibular AVM was successfully treated by endovascular therapy with Guglielmi detachable coils. On panoramic radiogram, mandibular AVMs can appear as cystic lesions without pathognomonic features. Several benign and malignant tumours of this anatomical region must be considered in the differential diagnosis.We emphasize the radiological sign of double enlarged mandibular canal and the diagnostic role of CT, particularly CT angiography, to discriminate a mandibular AVM from neoplastic entities of this region, sparing the risks of a needle biopsy.
我们描述了一例罕见的下颌骨高流量动静脉畸形(AVM),该病例发生在一名年轻男性身上,最初表现类似牙源性囊肿。下颌骨AVM的诊断通过CT血管造影做出,并经数字减影血管造影证实。CT扫描显示了下颌骨改变的范围以及同侧下颌管双重增粗。CT血管造影显示一个含有大动脉瘤的AVM。通过使用Guglielmi可脱卸弹簧圈进行血管内治疗,该下颌骨AVM得到成功治疗。在全景X线片上,下颌骨AVM可表现为无特征性表现的囊性病变。在鉴别诊断时必须考虑该解剖区域的几种良性和恶性肿瘤。我们强调下颌管双重增粗的影像学征象以及CT,尤其是CT血管造影在鉴别下颌骨AVM与该区域肿瘤性病变方面的诊断作用,避免了针吸活检的风险。