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Masticator Space Abnormalities Associated with Mandibular Osteoradionecrosis: MR and CT Findings in Five Patients

June Chonga, Lisa K. Hinckleya and Lawrence E. GinsbergGo,a

a From the MD Anderson Cancer Center, Department of Radiology, Houston, TX.



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  		FIG 1. Images of a 17-year-old male patient who underwent radiation for left-sided poorly differentiated squamous cell carcinoma of the nasopharynx.

A, Axial CT scan (bone window) shows ORN involving the mandibular ramus contralateral to the primary tumor site with cortical disruption and trabecular disorganization.

B, Unenhanced T1-weighted (400/9 [TR/TE]) MR image shows abnormal homogeneous signal hypointensity of the bone marrow of the right mandible (asterisk) and cortical disruption (arrowheads). Note that the right masticator muscles appear slightly larger than the contralateral side.

C, Axial T2-weighted (4000/105 [TR/TEeff]) MR image shows abnormal hyperintense signal of the marrow (asterisk) and adjacent masseter and pterygoid muscles (arrows).

D, Contrast-enhanced fat-saturated T1-weighted (400/9 [TR/TE]) MR image shows diffuse intense enhancement of the marrow (asterisk) and adjacent musculature (arrows).



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  		FIG 2. Images of a 49-year-old man treated for right-sided soft palate squamous cell carcinoma.

A, Coronal CT scan (bone window) shows cortical disruption and fragmentation of the right ramus.

B, Contrast-enhanced CT scan shows prominent thickening and enhancement of the adjacent masticator muscles. The buccal space is also involved (arrowheads).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X