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颌骨放射性骨坏死及药物相关性颌骨坏死的锥形束计算机断层扫描成像与组织病理学特征

CBCT imaging and histopathological characteristics of osteoradionecrosis and medication-related osteonecrosis of the jaw.

作者信息

Ogura Ichiro, Minami Yoshiyuki, Ono Junya, Kanri Yoriaki, Okada Yasuo, Igarashi Kensuke, Haga-Tsujimura Maiko, Nakahara Ken, Kobayashi Eizaburo

机构信息

Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.

Department of Pathology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.

出版信息

Imaging Sci Dent. 2021 Mar;51(1):73-80. doi: 10.5624/isd.20200230. Epub 2021 Jan 29.

Abstract

PURPOSE

The purpose of this study was to evaluate the cone-beam computed tomographic (CBCT) imaging and histopathological characteristics of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ).

MATERIALS AND METHODS

Ten surgical specimens from segmental mandibulectomy (3 ORN and 7 MRONJ) were analyzed using CBCT. The CBCT parameters were as follows: high-resolution mode (tube voltage, 90.0 kV; tube current, 4.00 mA; rotation time, 16.8 s; field of view, 56 mm×56 mm; thickness, 0.099 mm). Histopathological characteristics were evaluated using histological slides of the surgical specimens. The Pearson chi-square test was used to compare ORN and MRONJ in terms of CBCT findings (internal texture, sequestrum, periosteal reaction and cortical perforation) and histopathological characteristics (necrotic bone, inflammatory cells, reactive bone formation, bacteria, , and osteoclasts). A value less than 0.05 was considered to indicate statistical significance.

RESULTS

MRONJ showed periosteal reaction on CBCT more frequently than ORN (7 of 7 [100%] vs. 0 of 3 [0%], <0.05). Regarding histopathological characteristics, MRONJ showed osteoclasts more frequently than ORN (6 of 7 [85.7%] vs. 0 of 3 [0%], <0.05).

CONCLUSION

This study evaluated the CBCT imaging and histopathological characteristics of ORN and MRONJ, and the findings suggest that CBCT could be useful for the evaluation of ORN and MRONJ.

摘要

目的

本研究旨在评估放射性骨坏死(ORN)和药物相关性颌骨坏死(MRONJ)的锥束计算机断层扫描(CBCT)影像及组织病理学特征。

材料与方法

对10例节段性下颌骨切除术的手术标本(3例ORN和7例MRONJ)进行CBCT分析。CBCT参数如下:高分辨率模式(管电压90.0 kV;管电流4.00 mA;旋转时间16.8 s;视野56 mm×56 mm;层厚0.099 mm)。使用手术标本的组织学切片评估组织病理学特征。采用Pearson卡方检验比较ORN和MRONJ在CBCT表现(内部纹理、死骨、骨膜反应和皮质穿孔)及组织病理学特征(坏死骨、炎性细胞、反应性骨形成、细菌和破骨细胞)方面的差异。P值小于0.05被认为具有统计学意义。

结果

MRONJ在CBCT上出现骨膜反应的频率高于ORN(7例中的7例[100%]对比3例中的0例[0%],P<0.05)。在组织病理学特征方面,MRONJ出现破骨细胞的频率高于ORN(7例中的6例[85.7%]对比3例中的0例[0%],P<0.05)。

结论

本研究评估了ORN和MRONJ的CBCT影像及组织病理学特征,结果表明CBCT可用于ORN和MRONJ的评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf47/8007393/691996134a96/isd-51-73-g001.jpg

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