歯科放射線
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47 巻, 2 号
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原著
  • CT前額断像によるOsteomeatal unit（OMU：洞口鼻道系）と歯性上顎洞炎の関連
    加藤 美弥, 金田 隆, 加藤 正隆, 阪柳 雅志, 山下 芳枝, 藤田 雄三, 関谷 恵子, 森 進太郎, 小澤 薫
    2007 年 47 巻 2 号 p. 47-52
    発行日: 2007年
    公開日: 2007/11/20
    DOIhttps://doi.org/10.11242/dentalradiology.47.47
    ジャーナル フリー
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    Background and Objective: The ostiomeatal unit (OMU) incorporates the maxillary sinus ostium, infundibulum, uncinate process, hiatus semilunaris ethmoid bulla, middle turbinate and middle meatus. The maxillary ostium is located in the superior portion of the medial maxillary wall and drains into the posterior aspect of the ethmoid infundibulum. The detailed anatomy of the OMU as displayed by CT provides a road map for surgeons prior to endoscopic sinus surgery. However, little attention has been paid to the relationship between the OMU and odontogenic maxillary sinusitis. This study examined the relationship between the osteomeatal unit and odontogenic maxillary sinusitis using coronal CT images.
    Subjects and Methods: Materials consisted of 100 abnormal maxillary sinuses in 100 odontgenic maxillary sinusitis patients. Using coronal images, mucosal abnormalities were examined by grading expansion of the low density area, which represents the mucous membranes in the maxillary sinuses. Findings were classified into 3 types and the correlation between obstruction of the maxillary ostium and thickening of other sinonasal sinuses was examined.
    Results: Results of the grading were as follows: 25 maxillary sinuses were graded as type 1, 22 maxillary sinuses as type 2, and 53 maxillary sinuses as type 3. On pattern analysis using coronal CT images, there were significant differences in obstruction of the maxillary ostium based on thickening of the mucous membranes of the odontgenic maxillary sinusitis (p < 0.01); also there was a correlation between thickening of the mucous membranes of the ethmoid sinuses and thickening of the mucous membranes of the odontgenic maxillary sinusitis (p < 0.01).
    Thickening of the mucous membranes of both the ethmoid sinuses and frontal sinuses was well correlated with obstruction of the maxillary ostium on coronal CT images (p < 0.05). However, there was no correlation between obstruction of the maxillary ostium and sphenoid sinuses.
    Conclusion: Our study indicates that the severity of odontogenic maxillary sinusitis was well correlated with obstruction of the OMU on coronal CT images.
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  • 根尖病変の超音波診断
    ―CTとの比較―
    佐久間 久美子, 五十木 裕子, 田中 礼, 林 孝文
    2007 年 47 巻 2 号 p. 53-64
    発行日: 2007年
    公開日: 2007/11/20
    DOIhttps://doi.org/10.11242/dentalradiology.47.53
    ジャーナル フリー
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    Purpose: To clarify the clinical significance of sonography in the evaluation of periapical lesions in comparison with CT.
    Materials and methods: A control case without periapical lesions was examined by sonography and CT to investigate the normal sonographic anatomy around the tooth roots. A total of 8 periapical lesions in 7 patients were also examined by sonography and CT. The patients consisted of 3 males and 4 females ranging in age from 16 to 70 years with a mean age of 46.1 years. We compared sonographic findings of periapical lesions and CT features of cortical bone.
    Results: In the control, sonography demonstrated the cortical bone surface with a distinct surface echo but failed to depict the tooth roots. In the patients, periapical lesions were clearly observed on sonography in all of 4 lesions in which marked rupture of the labial / buccal cortical bone was demonstrated on CT. The periapical lesions were interpreted as hypoechoic and tooth root apices were observed within the lesion. Meanwhile, sonography failed to detect periapical lesions in two patients without rupture or thinning of the labial / buccal cortical bone on CT.
    Conclusions: Once the labial / buccal cortical bone of the lesion has disrupted, sonography can provide useful information about the extent of the periapical lesions and the location of the tooth root apices. However, no information about the periapical lesions can be expected from sonography if the labial / buccal cortical bone of the lesion remains normal.
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  • 2D-Look-Locker sequenceを使用したT1計測の試み
    筑井 徹, 瀬々 良介, 市原 隆洋, 湯浅 賢治, 吉浦 一紀
    2007 年 47 巻 2 号 p. 65-74
    発行日: 2007年
    公開日: 2007/11/20
    DOIhttps://doi.org/10.11242/dentalradiology.47.65
    ジャーナル フリー
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    A sequence for T1 relaxation-time measurement that allows a high resolution to be obtained within a short acquisition time is described herein and its application to the orofacial region is investigated. The sequence is based on the Look-Locker (LL) method and it employs a magnetization-preparation pulse prior to data acquisition with either a turbo field echo (TFE) or turbo field-echo echo-planar imaging (TFEPI) sequence. The sequence is implemented on a standard clinical scanner. We synchronized the data acquisition with the virtual electrocardiogram in order to set the time after the preparation pulse. Accuracy of the T1 results obtained by the LL sequence was evaluated and compared with those by the Inversion Recovery (IR) sequence by a phantom which consisted of 10 tubes of distilled water, with each tube containing a different concentration of the contrast media. The correlation between the T1 values obtained by the LL sequence and those by the IR sequence was high with an R2 of more than 0.99. The percentage difference was less than 4% between 500ms and 2000ms of the T1 values obtained by the IR sequence. As the flip angle increases, the difference in the percentage between the T1 values obtained by the IR sequence and those by the LL-TFE sequence thus become larger for the slow-relaxing compartment (T1 > 1500ms).
    However, the effect of the flip angle on the percentage difference by the LL-TFEPI sequence was smaller than that by the LL-TFE sequence. We therefore applied the LL sequence to the orofacial region and calculated the T1 value of various tissues. As a result, a close agreement was observed between the T1 values obtained by the LL-TFE sequence and by the LL-TFEPI sequence. The T1 values obtained with both sequences did not significantly differ (P = 0.55, paired t test).
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臨床
  • 眼窩内へ進展した非家族性ケルビズムの1例
    佐藤 しづ子, 阪本 真弥, 今井 啓道, 笹野 高嗣
    2007 年 47 巻 2 号 p. 75-81
    発行日: 2007年
    公開日: 2007/11/20
    DOIhttps://doi.org/10.11242/dentalradiology.47.75
    ジャーナル フリー
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    Cherubism is an unusual hereditary multilocular cystic disease of the jaws characterized by bilateral, painless enlargement. Lesion of the mandible and/or maxilla generally manifests in early childhood, and gradually increases until puberty. There have been only a few cases demonstrations extension into the orbit after puberty.
    We report here a case of cherubism with extension into the orbit in a 21-year-old Japanese woman. She presented with a complaint of symmetrical painless swelling of the cheeks and mandible. Her mandibular deformities had noticeably progressed after 20 years of age. Her family history did not include any evidence suggesting hereditary disease. Panoramic radiograph showed multilocular cystic radiolucency of the mandibule and maxilla, with root resorption of the mandibular incisors. CT images demonstrated a marked expansile lesion, consisting of soft tissue-intensity masses. Furthermore, the lesion of the right maxilla extended into the maxillary sinus, pterygopalatine fossa, and right orbit pushing the eyeball. On MRI, the jaw lesions showed a low signal intensity on T1-weighted image, and heterogeneously intermediate to high signal intensities on fat suppressed T2-weighted image. Bone scintigram (99mTc-MDP) showed extremely intense tracer uptake in the mandible and maxilla.
    The patient underwent partial resection of the lesions in order to minimize the cosmetic deformities. On pathological examination, the specimens were composed of fibrous connective tissue containing multinucleated giant cells. Moreover, genomic DNA sequencing found a Pro418Arg mutation in the SH3BP2 gene of the patient. Consequently, she was diagnosed as having cherubism. This is a rare case of nonfamilial cherubism with extension into the orbit, which progressed after puberty.
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写真供覧
第48回日本歯科放射線学会総会・学術大会記録
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