Kawai T, Murakami S, Kishino M, Matsuya T, Sakuda M, Fuchihata H
Department of Oral and Maxillofacial Radiology, Osaka University Dental Hospital, Japan.
Br J Oral Maxillofac Surg. 1998 Aug;36(4):304-10. doi: 10.1016/s0266-4356(98)90716-1.
We report detailed clinical and imaging findings of two patients with recurrent maxillary ameloblastoma. In one patient the recurrent tumour presented at follow-up examination 5 years after the initial operation. The other patients had a far advanced recurrent tumour with maxillary destruction extending into the adjacent normal structures including the infratemporal fossa, infraorbital fissure, masticator space and the left ethmoid sinus. The findings on conventional radiography including panoramic, posteroanterior and Waters' projection, and the findings of computed tomography (CT) and magnetic resonance (MR) imaging were evaluated using the following three variables: artefact degradation, lesion detectability, and conspicuity. The results suggested that MR imaging was the best imaging method for visualization of the tumours, followed by contrast enhanced CT. These two cases show that maxillary ameloblastoma can be difficult to control when it extends to the adjacent normal structures after destroying the maxilla. MR imaging was essential to establish the exact extent of the advanced maxillary ameloblastoma.
我们报告了两名复发性上颌成釉细胞瘤患者的详细临床和影像学表现。其中一名患者在初次手术后5年的随访检查中出现复发性肿瘤。另一名患者的复发性肿瘤进展程度很高，上颌骨破坏延伸至相邻正常结构，包括颞下窝、眶下裂、咀嚼肌间隙和左侧筛窦。使用以下三个变量评估全景、后前位和华氏位等传统X线摄影的表现以及计算机断层扫描（CT）和磁共振（MR）成像的表现：伪影程度、病变可检测性和清晰度。结果表明，MR成像是观察肿瘤的最佳成像方法，其次是增强CT。这两个病例表明，上颌成釉细胞瘤在破坏上颌骨后延伸至相邻正常结构时可能难以控制。MR成像对于确定晚期上颌成釉细胞瘤的确切范围至关重要。
