Watanabe Satoru, Nakajima Kenichi, Kinuya Seigo
Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan.
Jpn Dent Sci Rev. 2019 Nov;55(1):76-79. doi: 10.1016/j.jdsr.2018.12.002. Epub 2019 Mar 20.
Medication-related osteonecrosis of the jaw (MRONJ) is a significant side effect of antiresorptive and antiangiogenic drugs. Since MRONJ is intractable, early detection is the best way to limit progression. Bone scintigraphy and F- fluorodeoxyglucose positron-emission tomography can detect minimal and subclinical changes in bones earlier than conventional radiological modalities. A differential diagnosis including MRONJ is recommended when abnormally high uptakes are incidentally detected in the jaws of patients who have bone metastases. Quantitative analysis of uptakes, such as bone scan index of the jaw using neural network analysis and maximum standardized uptake value, could differentiate MRONJ from common dental diseases and be useful for the early detection and risk assessment of MRONJ.
药物相关性颌骨坏死（MRONJ）是抗吸收和抗血管生成药物的一种严重副作用。由于MRONJ难以治疗，早期检测是限制病情进展的最佳方法。骨闪烁显像和F-氟脱氧葡萄糖正电子发射断层扫描比传统放射学检查方法能更早地检测到骨骼中的微小和亚临床变化。对于骨转移患者颌骨偶然发现异常高摄取时，建议进行包括MRONJ在内的鉴别诊断。通过神经网络分析和最大标准化摄取值等摄取量的定量分析，可将MRONJ与常见牙科疾病区分开来，有助于MRONJ 的早期检测和风险评估。
