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不透射线颌骨病变的实用处理方法

Practical Approach to Radiopaque Jaw Lesions.

作者信息

Holmes Kenneth R, Holmes R Davis, Martin Montgomery, Murray Nicolas

机构信息

From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.).

出版信息

Radiographics. 2021 Jul-Aug;41(4):1164-1185. doi: 10.1148/rg.2021200187. Epub 2021 Jun 4.

Abstract

Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as densely sclerotic, ground glass, or () mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. RSNA, 2021.

摘要

颌骨的不透射线病变类型繁多,外观偶尔也变化不定。相应地,对这些病变进行放射学分析需要采用系统的方法,并广泛考虑临床和影像特征,以便做出可靠的放射学诊断。最初按衰减模式对病变进行分类,为组织不透射线颌骨病变提供了一个实用的框架,该框架也反映了重要的组织特征。具体而言,不透射线病变的外观可描述为致密硬化型、磨玻璃型或()溶骨-硬化混合型,每一类都代表一种独特的鉴别诊断,尽管偶尔会有重叠。在确定衰减模式后,了解其他放射学特征,如边缘特征或与牙齿的关系,以及包括人口统计学和症状在内的临床特征,有助于进一步缩小鉴别诊断范围,并为临床决策提供信心。作者回顾了不透射线颌骨病变的潜在病因,包括相关的临床和放射学特征,并概述了一种简化的放射学诊断方法,重点是横断面CT。RSNA,2021年。

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