We retrospectively reviewed the cases of 116 patients who underwent scintigraphy at the Okayama University Hospital Attached to Dental School. This study was done to learn more about the indications and the value of scintigraphy in the diseases of Oral and maxillo-facial region compared with CT scans and MR Imaging as well as conventional radiographic studies.
The
99mTc-MDP bone images provided very useful information for evaluating the presence of bony involvement, metastases of the remoted areas and the recurrence of the malignant tumors which escaped detection by conventional radiographs.
In the cases of malignant tumors, tumor size was correlated directly with the degree of uptake of
67Ga-citrate and small primary foci under the size of T1 did not result in a positive scan. The degree of abnormal uptake of
677Ga-citrate was correlated with the rate of the progression of malignant tumors, and
67Ga-citrate scans very useful for assessing the surrounding tissue infiltration of the maligmant tumors. But
67Ga-citrate scans provided less useful information in assessing metastases of the regional lymph nodes as compared with the usefulness of CT scans and MR Imaging.
While
99mTc-MDP bone images and
67Ga-citrate scans have proved most useful in the evaluation of metastases of the remoted ares and initial detection of the metastases depended entirely upon the scintigraphic findings in most cases.
The result of this study indicated that false positive findings by physiologic uptake and inflammation were seen in the areas of subauricular, submandibular and oral mucosa with
67Ga-citrate and in the lower and upper jaw bones with
99mTc-MDP bone images. These false positive uptake caused confusion to detect the malignant tumors. In inflammatory cases very active sites of infection accumulated enough
67Ga-citrate as compared with chronic inflammation. In the cases of chronic osteomyelitis of mandible, the
99mTc-MDP scans provided more subtle assessments of regional and total bony involvment of the inflammatory process as compared with that of conventional radiographic images. Thus, it was suggested that the use of scintigraphy might provide useful information for monitoring the pathological conditions of iniflammatory diseases.
99mTc-pertchnetate was most useful to evaluate the functional status of salivary gland and
67Ga-citrate was required for most effective evaluation of sialoadenitis. We found that the combined
99mTc-pertehhnetate and
67Ga-citrate scans provided most useful means of investigating the salivary gland tumors.
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