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Abstract

MR of mandibular invasion in patients with oral and oropharyngeal malignant neoplasms.

T S Chung, D M Yousem, H M Seigerman, B N Schlakman, G S Weinstein and R E Hayden
American Journal of Neuroradiology November 1994, 15 (10) 1949-1955;
T S Chung
Department of Diagnostic Radiology, Severance Hospital, Yonsei University, Seoul, Korea.
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D M Yousem
Department of Diagnostic Radiology, Severance Hospital, Yonsei University, Seoul, Korea.
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H M Seigerman
Department of Diagnostic Radiology, Severance Hospital, Yonsei University, Seoul, Korea.
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B N Schlakman
Department of Diagnostic Radiology, Severance Hospital, Yonsei University, Seoul, Korea.
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G S Weinstein
Department of Diagnostic Radiology, Severance Hospital, Yonsei University, Seoul, Korea.
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R E Hayden
Department of Diagnostic Radiology, Severance Hospital, Yonsei University, Seoul, Korea.
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Abstract

PURPOSE To investigate whether MR imaging is an accurate means of assessing mandibular invasion in patients with carcinoma.

METHODS We retrospectively studied the MR scans of 22 patients with pathologic or surgical confirmation of mandibular invasion from oral and oropharyngeal cancers. The MR images were blindly analyzed using primary criteria of: (a) cortical breakdown, (b) replacement of bone marrow fat, or (c) gadopentetate dimeglumine enhancement of a mass at the bone marrow defect. Secondary criteria of: (a) contiguous soft-tissue mass, and (b) mass on both sides of the mandibular cortex were also examined. Mandibular invasion was graded as periosteal/cortical, medullary, or no invasion.

RESULTS Primary positive findings of cortical breakdown and abnormal bone marrow signal were highly sensitive (100%) for periosteal/cortical invasion and medullary involvement, respectively. However, a high rate of false-positive studies hampered the MR accuracy, which fell into the 73% to 77% range. A negative MR study was highly predictive, but a positive study was less valuable. Gadolinium enhancement added little to the MR study's accuracy. False-positive studies mainly occurred in the setting of prior irradiation, osteoradionecrosis, and odontogenic infections.

CONCLUSIONS MR imaging is a sensitive method for detecting mandibular invasion but has a low positive predictive value. A negative study virtually excludes cortical/periosteal or bone marrow invasion.

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American Journal of Neuroradiology
Vol. 15, Issue 10
1 Nov 1994
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MR of mandibular invasion in patients with oral and oropharyngeal malignant neoplasms.
T S Chung, D M Yousem, H M Seigerman, B N Schlakman, G S Weinstein, R E Hayden
American Journal of Neuroradiology Nov 1994, 15 (10) 1949-1955;

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MR of mandibular invasion in patients with oral and oropharyngeal malignant neoplasms.
T S Chung, D M Yousem, H M Seigerman, B N Schlakman, G S Weinstein, R E Hayden
American Journal of Neuroradiology Nov 1994, 15 (10) 1949-1955;
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  • Dual-Isotope SPECT Using 99mTc-Hydroxymethylene Diphosphonate and 201Tl-Chloride to Assess Mandibular Invasion by Intraoral Squamous Cell Carcinoma
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