磁共振成像在牙根尖周病变中的临床应用价值

Clinical utility of MR imaging for diagnosing dental and periapical lesions

目的探讨磁共振成像(MRI)在诊断牙根尖周炎性病变中的临床应用价值。方法选取8名有牙髓及牙周病变的病例,对口腔上下颌牙进行MRI检查,分析牙根尖周病变的MRI表现,并与X线牙片进行对照。结果 8例均有牙根尖周炎症水肿表现,T1WI上信号减低,T2WI信号稍增高,脂肪抑制像上呈明显高信号,其中3例病变范围显示较普通X线牙片大,2例普通X线牙片显示正常而MRI显示有炎性病变,2例显示牙根尖与上颌窦囊肿的关系。结论 MRI可敏感地显示牙根尖周的炎性病理改变,MRI在显示病变的大小、范围及其与周围结构关系方面比X线片优越,并能显示普通X线牙片所不能显示的病理改变,MRI在牙根尖周炎性病变诊断中具有重要的临床应用价值。

Objective To investigate the clinical utility of magnetic resonance imaging（MRI） in the diagnosis of dental and periapical lesions.Methods Eight patients with dental pulpal and periapical lesions underwent MRI scans of the maxillary and mandibular teeth and then MRI findings of all the patients were prospectively analyzed and compared with those of dental radiographs.Results MRI demonstrated that there were dental and periapical inflammatory and edematous lesions in all 8 cases.The lesions were hypointensity on T 1WI,slight hyperintensity on T2WI,and marked hyperintensity on fat suppressed images.Of whom,3 cases whose the abnormality on MRI was considerably more extensive than that on intraoral radiographs;in 2 cases,MRI showed the inflammatory lesions which were not fount on dental radiographs,in other 2 cases,MRI showed the relationship between apex radicis dents and maxillary antrum cysts.Conclusion MRI scan could sensitively show dental and periapical inflammatory lesions and MRI in showing the size,extent of the lesions and their rela tionship with peripheral structures is obviously superior to dental radiography,especially could show the pathologic changes which could not be found by dental radiographs so that it has important utility in the diagnosis of dental and periapical lesions.