Al-Hammad Wlla E, Fujikura Mamiko, Hisatomi Miki, Okada Shunsuke, Munhoz Luciana, Kawazu Toshiyuki, Takeshita Yohei, Fujita Mariko, Yanagi Yoshinobu, Asaumi Jun-Ichi
Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan.
Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan.
Oncol Lett. 2023 Jul 27;26(3):394. doi: 10.3892/ol.2023.13980. eCollection 2023 Sep.
The accurate diagnosis of vascular anomalies (VAs) is considered a challenging endeavor. Misdiagnosis of VAs can lead clinicians in the wrong direction, such as the performance of an unnecessary biopsy or inappropriate surgical procedures, which can potentially lead to unforeseen consequences and increase the risk of patient injury. The purpose of the present study was to develop an approach for the diagnosis of VAs of the oral and maxillofacial region based on computed tomography (CT), magnetic resonance imaging (MRI) and dynamic contrast-enhanced MRI (DCE-MRI). In the present study, the CT and MR images of 87 VAs were examined, and the following imaging features were evaluated: Detectability of the lesion, the periphery of the lesion, the inner nature of the lesion, the density of the lesion on CT, the signal intensity of the lesion on MRI, the detectability of phleboliths and the shape of the lesion. A total of 29 lesions were further evaluated using the contrast index (CI) curves created from the DCE-MRI images. A diagnostic diagram, which is based on the imaging features of VAs and CI curve patterns, was subsequently extrapolated. The results obtained demonstrated that the VAs were detected more readily by MRI compared with CT, whereas the detectability of phleboliths was superior when using CT compared with MRI. VAs showed a propensity for homogeneous isodensity on CT, whereas, by contrast, they exhibited a propensity for heterogeneous hyperdensity on CE-CT. VAs also showed a propensity for homogeneous intermediate signal intensity when performing T1-weighted imaging (T1WI), heterogeneous high signal intensity when performing short tau inversion recovery MRI, and heterogeneous high signal intensity when performing fat-saturated CE-T1WI. The CI curves of VAs were found to exhibit a specific pattern: Of the 29 CI curves, 23 (79.3%) showed early weak enhancement, followed by a plateau leading up to 400-600 sec. An imaging-based diagnostic diagram was ultimately formulated. This diagram can act as an aid for radiologists when they are expecting to find a VA, and hopefully serve the purpose of simplifying the diagnostic process. Taken together, the findings of the present study indicated that DCE-MRI may be considered a useful tool for the diagnosis of VAs.
血管畸形（VAs）的准确诊断被认为是一项具有挑战性的工作。血管畸形的误诊可能会使临床医生误入歧途，例如进行不必要的活检或不适当的外科手术，这可能会导致不可预见的后果并增加患者受伤的风险。本研究的目的是基于计算机断层扫描（CT）、磁共振成像（MRI）和动态对比增强磁共振成像（DCE-MRI）开发一种诊断口腔颌面部血管畸形的方法。在本研究中，检查了87例血管畸形的CT和MR图像，并评估了以下影像学特征：病变的可检测性、病变的周边、病变的内部性质、CT上病变的密度、MRI上病变的信号强度、静脉石的可检测性以及病变的形状。使用从DCE-MRI图像创建的对比指数（CI）曲线对总共29个病变进行了进一步评估。随后推断出基于血管畸形影像学特征和CI曲线模式的诊断图。获得的结果表明，与CT相比，MRI更容易检测到血管畸形，而与MRI相比，使用CT时静脉石的可检测性更高。血管畸形在CT上倾向于表现为均匀等密度，而相比之下，在增强CT上它们倾向于表现为不均匀高密度。在进行T1加权成像（T1WI）时，血管畸形也倾向于表现为均匀中等信号强度，在进行短tau反转恢复MRI时表现为不均匀高信号强度，在进行脂肪饱和增强T1WI时表现为不均匀高信号强度。发现血管畸形的CI曲线呈现出一种特定模式：在29条CI曲线中，23条（79.3%）显示早期微弱增强，随后是一个平台期，直至400 - 600秒。最终制定了基于影像学的诊断图。当放射科医生期望发现血管畸形时，该图可以作为一种辅助工具，有望达到简化诊断过程的目的。综上所述，本研究结果表明DCE-MRI可能被认为是诊断血管畸形的一种有用工具。
