Department of Neuroradiology, Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2010 Dec;44(4):215-9. doi: 10.2478/v10019-010-0032-x. Epub 2010 Jun 24.
Bisphosphonates are drugs used in the treatment of lytic bone metastases, multiple myeloma, hypercalcemia of malignant origin, osteoporosis, and diseases such as Paget's disease. Recently osteonecrosis of the jaw has been associated with the use of bisphosphonates. This study describes the imaging findings of bisphosphonate-associated osteonecrosis of the jaws.
Eleven patients, receiving bisphosphonate medication for approximately 28 months, with pain on affected side, nonhealing extraction sockets, purulent discharge and swelling in soft tissue were examined. Imaging consisted of non-contrast enhanced CT and contrast enhanced MRI. All patients underwent surgery of affected bone and histology confirmed osteonecrosis.
CT scan showed osteolytic and sclerotic lesions with cortical bone destruction in all patients. The osteonecrosis was identified as delimited focal lesions with reduction of the signal on T1- weighted imaging and T2- weighted imaging. All the patients had soft-tissue involvement with enhancement in orbicular, buccinator muscle of the mouth or masticator space and adenopathy in submandibular and jugular digastric chain.
Bisphosphonate related osteonecrosis of the jaw presents a variety of imaging findings that help to determine the extent of the disease and track the progression, however they are not specific for this disease.
双膦酸盐是用于治疗溶骨性骨转移、多发性骨髓瘤、恶性来源高钙血症、骨质疏松症和 Paget 病等疾病的药物。最近，颌骨骨坏死与双膦酸盐的使用有关。本研究描述了双膦酸盐相关性颌骨骨坏死的影像学表现。
11 名患者因接受双膦酸盐治疗约 28 个月而出现受累侧疼痛、未愈合的拔牙窝、脓性分泌物和软组织肿胀，接受了非增强 CT 和增强 MRI 检查。所有患者均接受了受累骨的手术治疗，组织学证实为骨坏死。
CT 扫描显示所有患者均存在溶骨性和硬化性病变，伴有皮质骨破坏。骨坏死被确定为局限性局灶性病变，T1 加权成像和 T2 加权成像信号降低。所有患者均有软组织受累，表现为眶下、口轮匝肌或咀嚼肌间隙增强，以及颌下和颈内二腹肌链淋巴结肿大。
双膦酸盐相关性颌骨骨坏死的影像学表现多种多样，有助于确定疾病的范围和跟踪进展，但这些表现并不特异于该疾病。
