Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Clin Oral Investig. 2023 Sep;27(9):5403-5412. doi: 10.1007/s00784-023-05159-z. Epub 2023 Jul 18.
To detect and evaluate early signs of apical periodontitis using MRI based on a 3D short-tau-inversion-recovery (STIR) sequence compared to conventional panoramic radiography (OPT) and periapical radiographs in patients with apical periodontitis.
Patients with clinical evidence of periodontal disease were enrolled prospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR sequence. The MRI sequences were assessed for the occurrence and extent of bone changes associated with apical periodontitis including bone edema, periradicular cysts, and dental granulomas. OPTs and intraoral periapical radiographs, if available, were assessed for corresponding periapical radiolucencies using the periapical index (PAI).
In total, 232 teeth of 37 patients (mean age 62±13.9 years, 18 women) were assessed. In 69 cases reactive bone edema was detected on MRI with corresponding radiolucency according to OPT. In 105 cases edema was detected without corresponding radiolucency on OPT. The overall extent of edema measured on MRI was significantly larger compared to the radiolucency on OPT (mean: STIR 2.4±1.4 mm, dental radiograph 1.3±1.2 mm, OPT 0.8±1.1 mm, P=0.01). The overall PAI score was significantly higher on MRI compared to OPT (mean PAI: STIR 1.9±0.7, dental radiograph 1.3±0.5, OPT 1.2±0.7, P=0.02).
Early detection and assessment of bone changes of apical periodontitis using MRI was feasible while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT.
In clinical routine, dental MRI might be useful for early detection and assessment of apical periodontitis before irreversible bone loss is detected on conventional panoramic and intraoral periapical radiographs.
通过与传统全景放射摄影术（OPT）和根尖放射摄影术相比，使用基于三维短 tau 反转恢复（STIR）序列的 MRI 检测和评估根尖周炎的早期征象。
前瞻性纳入有临床牙周病证据的患者，对其进行 OPT 检查以及包括三维 STIR 序列在内的颅内脏器 MRI 检查。评估 MRI 序列中与根尖周炎相关的骨变化的发生和程度，包括骨水肿、根尖周囊肿和牙源性肉芽肿。如果有条件，还会使用根尖指数（PAI）评估 OPT 和口腔内根尖放射照片中相应的根尖透光区。
共评估了 37 名患者的 232 颗牙齿（平均年龄 62±13.9 岁，女性 18 名）。在 69 例中，MRI 上检测到反应性骨水肿，与 OPT 对应的透光度一致。在 105 例中，在 OPT 上未检测到水肿，但检测到水肿。MRI 上测量的水肿总范围明显大于 OPT 上的透光区（平均：STIR 2.4±1.4mm，牙射线照相 1.3±1.2mm，OPT 0.8±1.1mm，P=0.01）。MRI 上的总体 PAI 评分明显高于 OPT（平均 PAI：STIR 1.9±0.7，牙射线照相 1.3±0.5，OPT 1.2±0.7，P=0.02）。
使用 MRI 早期检测和评估根尖周炎的骨变化是可行的，而 MRI 上测量的骨水肿范围超过 OPT 上测量的透光区。
在临床常规中，在传统全景和口腔内根尖放射照片上检测到不可逆骨丢失之前，牙科 MRI 可能有助于早期检测和评估根尖周炎。
