Accurate diagnosis using CT requires that CT values for normal tissues be known. In this study, CT values of three masticatory muscles, i.e., the masseter and medial and lateral pterygoid muscles, and the sternocleidomastoid muscle were measured on both plain and enhanced CT images. The normal range of values for each muscles, difference between the right and left values, and correlation with age were also investigated. CT value was measured on display images at setting a circular ROI and the average of 2 or 3 contiguous sections was calculated.
The results were as follows:
1. There was a close correlation between the right and left CT values of all muscles on both plain and enhanced images.
2. CT value difference between the right and left sides was found to be slightly greater in the masticatory muscles than in the sternocleidomastoid muscle, and it tended to increase with contrast enhancement.
3. There was no significant difference between the CT values of the masseter and medial pterygoid muscles on both plain and enhanced images.
4. There was no sex differnce in CT value of all muscles measured.
5. The CT values on enhanced CT images were higher than those on plain images in all muscles measured, and the variance was increased in the sternocleidomastoid muscle.
6. CT values of the muscles tended to decrease with age.

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We assessed on panoramic radiograms the change in maximum vertical diameter of the domeshaped soft-tissue shadow in the maxillary sinus, with various intervals of the panoramic radiography examinations. When compared with patients who had passed the intervals without any treatment, intervening surgeries to the teeth or alveolar bone performed during the intervals between two X-ray examinations greatly increased or decreased maximum diameter of the dome-shaped soft-tissue shadow (s) or even produced new dome-shaped shadows in the maxillary sinus on the same side of the intervention. Anesthesia peformed under nasotracheal intubation with or without local surgical interventions resulted in a higher incidence of changes in the maximum diameter of the dome-shaped shadows than in patients received local surgical interventions to the tooth or alveolar bone on the same side. These results suggest that the dome-shaped shadows in the maxillary sinus are liable to change their sizes against external stimuli such as local surgical treatments to the tooth or alveolar bone on the same side or injury in the nasal cavity that may cause inflammatory changes in the maxillary sinus.

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Cementifying fibroma is a rare benign tumor that forms cementums into fibrous conective tissue. Generally, cementifying fibroma presents variable radiographic appearance depending upon its stage of development. In its early stages the cementifying fibroma appears as a radiolucent lesion so-called “osteolytic” stage. As the mature stages radiolucent area becomes flecked with opacities so-called “cementoblastic” stage. In this study, we report two cases of cementifying fibroma. Case 1 is diagnosed as benign tumor of jaw, showing aggressively expansile with opacification between the lower left canine and first premoler in radiograph and case 2 is diagnosed as odontogenic tumor of jaw, showing welldefind margin and multiloculor radiolucency in the second molor superimposed over teeth in radiograph.
Our cases suggest that differential diagnosis would be difficult on radiograph for such a cementifying fibroma which shows changeable pattern of radiograph depending on the stage.

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In recent years, fungal sinusitis in not immunocompromised patients has been reported not so rarely as previously thought. As the disease is resistant to conservative treatment, it is important to distinguish the fungal sinusitis from chronic non-fungal ones or malignant diseases. In this paper, radiographic findings of six patients with fungal sinusitis were analysed and literature of this disease was reviewed. The relation between pathogenic mechanism and radiograhic findings was also discussed.
The six patients comprising five women and one man, ranged in age from 29 to 64 years, with a mean age of 45.3 years. Four of the six patients were thought to be associated with odontogenic lesions and/or inappropriate dental procedures (“odontogenic factor”). Radical surgery was carried out for all cases and the diagnosis of Aspergillosis was made by histological examinationin. The “fungus ball” and calcification in it was also proved on removed material.
Plain radiographs of all six patients showed the loss of radiolucency of unilateral maxillary sinus and/or other paranasal sinuses on the same side. In three of the four cases associated with an odontogenic factor, a foreign body was visualised in the maxillary sinus, one was a root tip and remaining ones were seemingly a fragments of dental paste spilled over from the upper first molar. Soft tissue shadow of a fungus ball was seen in one case.
Five of the six patients underwent computed tomography (CT). On CT of all five cases, a soft tissue density was visualised in the unilateral maxillary sinus and/or other paranasal sinuses on the same side, and the soft tissue bulged out toward the nasal cavity at the level of the middle nasal concha. A sand-like high density area, which was separated from sinus wall, was found in the soft tissue in four of the five cases.
Fungal sinusitis is thought to be aerogenic infection through the nasal pathways. The findings of disappearance or destruction of the medial wall of maxillary sinus and a soft tissue bulging toward nasal cavity seem to support this hypothesis. But, not a few cases have odontogenic factor, and fungal sinusitis always affects almost unilateral side of paranasal sinus as in odontogenic sinusitis. So, it is thought that the odontogenic factor is not a direct cause of infection but one of the causes of initiating and/or accelerating the clinical process of fungal sisunsitis.

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