Neuroimaging clinics of North America
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Malignant tumors of the mandible and maxilla are grouped into primary tumors that originate within the mandible and secondary lesions, predominantly oral cancers and metastatic lesions, that involve the mandible secondarily. The most common malignant tumors of the mandible represent SCCs of the oral cavity, notably carcinoma of the floor of the mouth and gingiva that invade the mandible secondarily. Metastatic disease, most commonly from the breast and lung, are not an uncommon malignant lesion in the mandible and may be the first manifestation of a malignant lesion outside the head and neck. ⋯ CT is indicated for assessment of bone destruction in the mandible before surgery or radiation therapy. MR imaging is the optimal modality for the assessment of marrow involvement and evaluation of the extraosseous soft tissue component. Finally, conventional films, frequently a Panorex view, are the initial radiographic examinations in suspected lesions.
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewThe temporomandibular joint: clinical and surgical aspects.
Advances in imaging techniques have greatly enhanced the ability to visualize the internal anatomy of the temporomandibular joint and have increased understanding of the etiology of many temporomandibular disorders. When used together with careful history and physical examination, this knowledge can contribute to better treatment outcomes.
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewMalignant tumors of the oral cavity and oropharynx: clinical, pathologic, and radiologic evaluation.
Carcinomas of the oral cavity and oropharynx constitute approximately 2% to 5% of head and neck cancers. Alcohol abuse and tobacco chewing, including chewing Shamma, predispose individuals to the development of cancer in the oral cavity. CT and MR imaging are best suited in the evaluation of cancer of the oral cavity and oropharynx. ⋯ Some malignant lesions may mimic a benign tumor, such as the adenoid cystic or mucoepidermoid carcinoma. Histopathologic diagnosis is therefore necessary for the final diagnosis before treatment by surgery or radiotherapy. PET scanning is indicated in the following instances: in search of an unknown primary tumor in patients who have a neck mass secondary to carcinoma, if a recurrent carcinoma may be present, when there are metastatic N0 lymph nodes in the neck, or where CT is inconclusive for metastatic lymph nodes in the neck.
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Before application of any cross-sectional imaging modality, the orthopanoramic view is indispensable in assessing the status of dentition, in recognizing direct radiographic signs of osteomyelitis, or in determining the presence of predisposing conditions such as a fracture or systemic bone disease. The orthopanoramic view is the procedure of choice in follow-up examinations in patients who have osteomyelitis. In acute osteomyelitis, the higher sensitivity of MR imaging for detection of intramedullary inflammation advocates this imaging modality for confirmation of the clinical diagnosis. ⋯ In chronic osteomyelitis, the higher sensitivity of MR imaging to detect periosteal inflammation and soft tissue involvement advocates this modality to reveal the presence, location, and extent of chronic inflammation. The assessment of persistence or recurrence of chronic inflammation after surgical treatment is by high-resolution CT for the first 6 months following surgery. Finally, scintigraphy is recommended when multi-focal systemic disease is suspected, such as in CRMO and SAPHO syndrome.
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewFibro-osseous and giant cell lesions, including brown tumor of the mandible, maxilla, and other craniofacial bones.
Fibro-osseous, osseous, cartilaginous, and giant cell lesions of the mandible, maxilla, and other craniofacial bones share overlapping clinical, radiologic, and pathologic features that may lead to diagnostic confusion and possible misdiagnosis. The value of combined clinical-radiologic-pathologic correlation in the diagnosis of these lesions is paramount to achieving the correct diagnosis with subsequent implementation of appropriate therapeutic intervention.