Magnetic resonance imaging in the diagnosis of malignant tumors of the maxillofacial region.

Magnetic resonance imaging (MRI) is a radiological imaging method that has not yet found routine application in the detection and assessment of malignant tumors of the maxillofacial region. The aim of this study was to evaluate MRI in the detection, diagnosis and differential diagnosis of malignant tumors of the maxillofacial region. This prospective study included 42 patients with clinically confirmed malignant tumors of the maxillofacial region. All patients were examined by MRI. This imaging method was evaluated for the ability to detect tumor location and to analyze dimensions and structure of the tumor, bone involvement, effect on neurovascular structures and extension to soft tissues. MRI results were compared with histopathologic and intraoperative findings as the 'gold standard' methods. MRI identified all of the clinically confirmed tumors. The sensitivity for tumor location was 94.4%, tumor necrosis 93%, hemorrhage 93.3% and bone involvement 91.4%. The specificity for tumor location was 84%, tumor necrosis 92.8%, hemorrhage 92.8% and bone involvement 85.7%. In the evaluation of soft tissue tumor extension to bone structures, MRI sensitivity and specificity was 94.4% and 88.2%, respectively. The sensitivity for perineural infiltration and tumor involvement of vascular structures was 91% and 91.6%, respectively. The specificity for perineural infiltration was 96.7% and for tumor involvement of vascular structures 88%. MRI sensitivity and specificity for intracranial extension, intraorbital propagation, extension to pterygopalatine fossa and other surrounding anatomic spaces was 93.5% and 90.9%, respectively. MRI proved advantageous for the ability to distinguish neurovascular structures from adjacent soft tissues without the use of intravenous contrast media. Study results demonstrated MRI to provide valuable information in the analysis of tumor structure, bone involvement and extension to soft tissues of malignant tumors of the maxillofacial region.