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Visualising cervical lymph nodes in jaw osteonecrosis using diffusion-weighted imaging.

Hirotaka Muraoka1, Takashi Kaneda1, Takumi Kondo1

  • 1Department of Radiology, Nihon University School of Dentistry at Matsudo 2-870-1 Sakaecho-Nishi, Matsudo, Japan.

Oral Diseases
|March 22, 2024
PubMed
Summary

Diffusion-weighted imaging effectively differentiates medication-related osteonecrosis of the jaw (MRONJ) in cervical lymph nodes. This technique aids in the early detection of MRONJ, distinguishing it from other lymph node conditions.

Keywords:
cervical lymph nodesdiffusion‐weighted imagingmagnetic resonance imagingmedication‐related osteonecrosis of the jaw

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Area of Science:

  • Radiology
  • Oncology
  • Oral and Maxillofacial Surgery

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) can affect cervical lymph nodes.
  • Accurate evaluation of these lymph nodes is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the utility of diffusion-weighted imaging (DWI) in assessing cervical lymph nodes in patients with MRONJ.
  • To determine if DWI can differentiate MRONJ-affected lymph nodes from those in healthy controls.

Main Methods:

  • A retrospective analysis of DWI data from 70 patients with and without MRONJ (Stages 0-3).
  • Calculation of apparent diffusion coefficient (ADC) values for submandibular (level IB) and superior internal jugular (level IIA) lymph nodes.
  • Statistical analysis using the Mann-Whitney test and receiver operating characteristic (ROC) curve analysis.

Main Results:

  • Median ADC values were significantly different between control and MRONJ groups for both level IB and level IIA nodes.
  • ROC analysis demonstrated that ADC values possess excellent ability to discriminate between MRONJ-affected and control lymph nodes.

Conclusions:

  • Diffusion-weighted imaging is a valuable tool for differentiating MRONJ-related cervical lymph node changes.
  • DWI facilitates the early detection of MRONJ, aiding in differential diagnosis from other cervical lymph node pathologies.