Kim Jo-Eun, Yoo Sumin, Choi Soon-Chul
Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul, Korea.
School of Dental Hygiene, Kyungdong University Medical Campus, Wonju, Korea.
Imaging Sci Dent. 2020 Dec;50(4):273-279. doi: 10.5624/isd.2020.50.4.273. Epub 2020 Dec 15.
This review presents an overview of some diagnostic imaging-related issues regarding medication-related osteonecrosis of the jaws (MRONJ), including imaging signs that can predict MRONJ in patients taking antiresorptive drugs, the early imaging features of MRONJ, the relationship between the presence or absence of bone exposure and imaging features, and differences in imaging features by stage, between advanced MRONJ and conventional osteomyelitis, between oncologic and osteoporotic patients with MRONJ, and depending on the type of medication, method of administration, and duration of medication. The early diagnosis of MRONJ can be made by the presence of subtle imaging changes such as thickening of the lamina dura or cortical bone, not by the presence of bone exposure. Most of the imaging features are relatively non-specific, and each patient's clinical findings and history should be referenced. Oral and maxillofacial radiologists and dentists should closely monitor plain radiographs of patients taking antiresorptive/antiangiogenic drugs.
本综述概述了与颌骨药物性骨坏死（MRONJ）相关的一些诊断成像问题，包括可预测服用抗吸收药物患者发生MRONJ的成像征象、MRONJ的早期成像特征、骨暴露与否与成像特征之间的关系，以及不同阶段的成像特征差异、晚期MRONJ与传统骨髓炎之间的差异、患有MRONJ的肿瘤患者和骨质疏松患者之间的差异，以及取决于药物类型、给药方法和用药持续时间的差异。MRONJ的早期诊断可依据诸如硬骨板或皮质骨增厚等细微成像变化来做出，而非依据骨暴露的存在。大多数成像特征相对不具特异性，应参考每位患者的临床发现和病史。口腔颌面放射科医生和牙医应密切监测服用抗吸收/抗血管生成药物患者的X线平片。
