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AJNR - American Journal of Neuroradiology

Publication Preview: Published January 9, 2008

American Journal of Neuroradiology 2008;29:716.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A0897

HEAD & NECK

Malignant Tumors and Chronic Infections in the Masticator Space: Preliminary Assessment with In Vivo Single-Voxel ¹H-MR Spectroscopy

Q. Yu, J. Yang and P. Wang

From the Department of Radiology (Q.Y., P.W.), Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China; the Division of Oral and Maxillofacial Radiology (J.Y.), Temple University School of Dentistry, and the Department of Diagnostic Imaging, Temple University School of Medicine, Philadelphia, Pa.

Please address correspondence to Qiang Yu, DDS, Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, P. R. China; e-mail: yuqiang6155{at}163.com

BACKGROUND AND PURPOSE: Differential diagnosis between malignant tumors and chronic infections in the masticator space remains challenging. The purpose of the study was to categorize various changes of both lesions by using single-voxel ¹H-MR spectroscopy.

MATERIALS AND METHODS: Twenty-four masticator space lesions, 7 chronic infections, and 17 malignant tumors were assessed with ¹H-MR spectroscopy before treatment procedures. The MR spectroscopic findings were compared with surgical and histopathologic results. Localization technique for ¹H-MR spectroscopy was made by a point-resolved spectroscopy sequence at an echo time of 144 ms. Choline (Cho) signals (identified at 3.2 ppm) and Cho signal intensity-to-noise ratio (Cho/noise) were considered as evaluating criteria.

RESULTS: All the lesions were found with 3 ¹H-MR spectroscopic types: type 1, lesions without Cho signals (3 chronic infections); type 2, lesions with Cho signals and Cho/noise ratio <3 (4 chronic infections and 4 malignant tumors); and type 3, lesions with Cho signals and Cho/noise ratio >3 (13 malignant tumors). The mean ± SD of the Cho/noise ratio between chronic infections and malignant tumors was 2.31 ± 0.19 and 5.76 ± 3.29 (P < .01), respectively.

CONCLUSION: In vivo single-voxel ¹H-MR spectroscopy may be helpful in the assessment of masticator space lesions. Differences of Cho signals and Cho/noise ratios between malignant tumors and chronic infections provide valuable information in the differentiation of these 2 lesions.