双膦酸盐相关颌骨坏死与放射性骨坏死的影像学表现比较
Image findings of bisphosphonate related osteonecrosis of jaws comparing with osteoradionecrosis.
作者信息
Obinata Kenichi, Shirai Shinichi, Ito Hitoshi, Nakamura Motoyasu, Carrozzo Marco, Macleod Iain, Carr Andrew, Yamazaki Yutaka, Tei Kanchu
机构信息
1 Omni Dentix, Dartmouth, Sapporo, Hokkaido, Japan.
2 Nakamura Dental Clinic, Sapporo, Hokkaido, Japan.
出版信息
Dentomaxillofac Radiol. 2017 Jul;46(5):20160281. doi: 10.1259/dmfr.20160281. Epub 2017 Mar 16.
OBJECTIVES
The aim of this study was to evaluate image characteristics of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and compare these with osteoradionecrosis (ORN).
METHODS
34 patients with BRONJ and 16 patients with ORN were included in this study. We investigated the CT and dental panoramic radiograph (DPR) images for osteolysis, osteosclerosis, sequestration, periosteal reaction, pathological fracture and spread of soft tissue inflammation around the jaws.
RESULTS
Osteolysis, osteosclerosis, sequestration and spread of soft tissue inflammation around the jaws were common radiological features in both BRONJ and ORN. Osteolysis and spreading of soft tissue inflammation around the jaws were predominant in ORN, and by contrast osteosclerosis was predominant in BRONJ. Periosteal reaction was established in 15 of the 34 BRONJ cases, but none in the ORN cases. Pathological fractures were observed in 6 of 16 ORN cases, but none in BRONJ cases. CT was better for detection than DPR for osteolysis, osteosclerosis, sequestration and periosteal reactions.
CONCLUSIONS
Image findings of BRONJ were characterized as a severe sclerotic change combined with osteolysis, sequestration, periosteal reaction and spread of soft tissue inflammation around the jaws.
目的
本研究旨在评估双膦酸盐相关颌骨坏死（BRONJ）的影像特征，并与放射性骨坏死（ORN）进行比较。
方法
本研究纳入了34例BRONJ患者和16例ORN患者。我们对CT和口腔全景X线片（DPR）图像进行了研究，观察颌骨周围的骨质溶解、骨质硬化、骨分离、骨膜反应、病理性骨折以及软组织炎症扩散情况。
结果
骨质溶解、骨质硬化、骨分离以及颌骨周围软组织炎症扩散是BRONJ和ORN共同的影像学特征。ORN以骨质溶解和颌骨周围软组织炎症扩散为主，相比之下，BRONJ以骨质硬化为主。34例BRONJ病例中有15例出现骨膜反应，而ORN病例中无一例出现。16例ORN病例中有6例观察到病理性骨折，BRONJ病例中无一例出现。对于骨质溶解、骨质硬化、骨分离和骨膜反应，CT的检测效果优于DPR。
结论
BRONJ的影像表现特征为严重的硬化改变，同时伴有骨质溶解、骨分离、骨膜反应以及颌骨周围软组织炎症扩散。
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