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Imaging study of ameloblastomas of the jaw

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Author:: No author available

Journal Title:: CHINESE JOURNAL OF RADIOLOGY

Issue:: 6

DOI:: 10.3760/j.issn:1005-1201.2006.06.002

Key Word:: 牙源性肿瘤;颌肿瘤;体层摄影术,X线计算机;磁共振成像

Abstract：目的研究颌骨造釉细胞瘤的影像学特征,探讨CT、MRI对颌骨造釉细胞瘤的诊断及鉴别诊断价值.方法回顾分析20例经手术病理证实的颌骨造釉细胞瘤的CT(20例)、MRI(10例)表现.观察病变的部位、形态、内部结构、邻近结构侵犯及囊内容物密度和(或)信号特征等.结果20例中,14例位于下颌磨牙与升支区,其他部位少见.CT表现:20例中,病变呈多房型13例,单房型7例;肿瘤造成邻近骨质缺损18例,其中9例缺损范围超过囊壁周长的1/2,5例肿瘤穿破邻近骨皮质,形成局部软组织肿块;9例牙根吸收,呈截断状;18例造成邻近重要结构(下颌管、上颌窦、鼻腔等)的侵犯;囊变区CT值范围为9.5～31.4 HU,平均21.2 HU.MRI表现:10例中,5例呈囊实性,实性部分均呈等T1、等T2信号;另5例呈纯囊性,其中4例呈不规则厚壁,1例囊壁见乳头状突起;囊内容物呈均一长T1、长T2信号7例,呈不均匀混杂信号3例.增强检查6例中,4例实体部分呈明显均一强化,2例囊壁呈明显不规则强化.结论造釉细胞瘤在发生部位、形态、内部结构及邻近结构侵犯等方面均具有一定的特征性.高分辨螺旋CT配合二维曲面牙科软件技术可显示病变的形态、周围骨质破坏、牙根吸收及邻近重要结构改变;MRI对于软组织成分的显示优于CT,二者联合应用对于提高造釉细胞瘤的术前诊断正确率有重要价值.

Reference

[1]M K, Sehdev,A G, Huvos,E W, Strong,etc.Proceedings: Ameloblastoma of maxilla and mandible.[J].1974,33.
[2]L, Heffez,M F, Mafee,J, Vaiana.The role of magnetic resonance imaging in the diagnosis and management of ameloblastoma.[J].1988,65.
[3]邹兆菊,马绪臣主编.口腔颌面医学影像诊断学[M].1997.
[4]Sandra F,Ohishi M,Mitsuyasu T,etc.Growth characteristics of ameloblastoma involving the inferior alveolar nerve: a clinical and histopathologic study.[J].2001,91(5).
[5]A L, Weber.Imaging of cysts and odontogenic tumors of the jaw. Definition and classification.[J].1993,31.
[6]王文崔,王贤俶主编.临床颌骨外科学[M].1994.
[7]Y, Hertzanu,D B, Mendelsohn,M, Cohen.Computed tomography of mandibular ameloblastoma.[J].1984,8.
[8]Kruger HE,van-Rensburg LJ,Thompson IO,etc.Hemangiomatous ameloblastoma: Clinical, radiologic, and pathologic features.[J].2001,91(3).
[9]M, Minami,T, Kaneda,H, Yamamoto,etc.Ameloblastoma in the maxillomandibular region: MR imaging.[J].1992,184.
[10]赵文川编著.口腔颌面肿瘤学[M].2003.
[11]Minami M,Kaneda T,Ozawa K,etc.Cystic lesions of the maxillomandibular region: MR imaging distinction of odontogenic keratocysts and ameloblastomas from other cysts.[J].1996.
[12]张润荃.WHO牙源性肿瘤组织学分类（1992）（连载之一）[J].1996,(1).
[13]Fukuda K,Tanabe H,Tozaki M,etc.Dynamic Multislice Helical CT of Ameloblastoma and Odontogenic Keratocyst: Correlation Between Contrast Enhancement and Angiogenesis.[J].2002,26(6).
[14]Yildirim H,Akfirat M,Cihangiroglu M.CT and MRI findings of ameloblastoma in two cases.[J].2002,44(5).
[15]Bodner Lipa,Bar-Ziv Jacob,Kaffe Israel.CT of Cystic Jaw Lesions[J].1994.
[16]Mark A. Cohen,Yancu Hertzanu,Dianne B. Mendelsohn.Computed tomography in the diagnosis and treatment of mandibular ameloblastoma: Report of cases[J].1985,43(10).