Körner T, Kreusch T, Bohuslavizki K H, Brinkmann G, Köhnlein S
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Christian-Albrechts-Universität Kiel.
Mund Kiefer Gesichtschir. 1997 Nov;1(6):324-7. doi: 10.1007/BF03043576.
Bone scintigraphy is routinely used in the diagnosis of lower jaw osteomyelitis; however, the radiation dosage of 3.5 mSv is quite high. Magnetic resonance imaging (MRI) gives information about soft tissue and bone marrow alterations. This study compares the sensitivity of the two imaging modalities in the diagnosis of lower jaw osteomyelitis. Thirteen patients with clinical signs of the disease were examined and followed up using both methods, three-phase bone scintigraphy and MRI. Compared to three-phase bone scintigraphy, MRI has the same diagnostic sensitivity. However in one case of active osteomyelitis bone scintigraphy showed a false-negative result. MRI once indicated a higher activity rate but never failed to provide the diagnosis. In addition, it gives exact information about the location, size and involvement of the soft tissue. A STIR sequence should be performed in addition to the native and contrast-enhanced T1-weighted spin echo sequence. The metal artifacts of the antibiotic chain on the MRI can be eliminated by replacing the wire by nonresorbent suture material. In the diagnosis of lower jaw osteomyelitis, three-phase bone scintigraphy can be replaced by the MRI.
骨闪烁扫描术常用于诊断下颌骨骨髓炎；然而，3.5毫希沃特的辐射剂量相当高。磁共振成像（MRI）可提供有关软组织和骨髓改变的信息。本研究比较了这两种成像方式在诊断下颌骨骨髓炎方面的敏感性。对13例有该疾病临床症状的患者使用三相骨闪烁扫描术和MRI这两种方法进行检查及随访。与三相骨闪烁扫描术相比，MRI具有相同的诊断敏感性。然而，在1例急性骨髓炎病例中，骨闪烁扫描术显示为假阴性结果。MRI曾显示出更高的活动率，但从未无法做出诊断。此外，它能提供有关软组织的位置、大小及受累情况的确切信息。除了常规和增强对比的T1加权自旋回波序列外，还应进行短TI反转恢复（STIR）序列检查。通过用不可吸收缝合材料替换金属丝，可消除MRI上抗生素链的金属伪影。在诊断下颌骨骨髓炎时，三相骨闪烁扫描术可被MRI取代。
