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Dynamic MR imaging of mandibular osteoradionecrosis
G Støre1, H J Smith, T A Larheim
1Department of Maxillo-Facial Surgery, National Hospital, Oslo, Norway.
Acta Radiologica (Stockholm, Sweden : 1987)
|February 9, 2000
Summary
Dynamic contrast-enhanced MRI reveals increased vascularity in osteoradionecrotic (ORN) mandibular bone, contrary to previous assumptions. Hyperbaric oxygen therapy showed varied effects on this enhanced vascularity in ORN patients.
Area of Science:
- Radiology
- Oncology
- Oral Surgery
Background:
- Osteoradionecrotic (ORN) bone is typically considered hypovascular with impaired perfusion.
- Understanding the vascularity of ORN bone is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the vascularity of radionecrotic mandibular bone using dynamic contrast-enhanced MRI.
- To determine if this imaging technique can offer additional insights into ORN bone perfusion.
Main Methods:
- Dynamic contrast-enhanced MRI was performed on 10 patients with mandibular ORN.
- A control group of 6 patients irradiated for oropharyngeal tumors without ORN was also scanned.
- Nine ORN patients underwent 20 hyperbaric oxygen (HBO) treatments, followed by repeat MRI.
Main Results:
- Radiation alone did not increase contrast enhancement in bone.
- All ORN patients exhibited significant contrast enhancement in osteoradionecrotic bone marrow.
- Following HBO treatment, 7 of 9 ORN patients showed reduced contrast enhancement rates, while 2 had increased rates.
Conclusions:
- ORN bone marrow demonstrates increased and patent microvasculature.
- Dynamic contrast-enhanced MRI is a valuable tool for assessing ORN vascularity.
- Hyperbaric oxygen therapy has a variable impact on the microvasculature of ORN bone.