BackgroundMagnetic resonance imaging is considered a preferable imaging examination in the diagnosis of inflammatory maxillary sinus disease and can provide precise sinonasal characterization. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient are complementary magnetic resonance imaging tools that can be applied to the differentiation of sinus diseases. In this report, 3 cases of inflammatory maxillary sinus diseases imaging findings considering diffusion-weighted magnetic resonance imaging features were described. Additionally, a literature review considering the use of diffusion-weighted magnetic resonance imaging in inflammatory lesions is provided.MethodsThe cases reported were: presence of air-fluid levels, mucosal thickening and a mucous retention cyst. Conventional magnetic resonance imaging and apparent diffusion coefficient (ADC) maps, with ADC values were demonstrated. In the literature review, the studies considering inflammatory lesions were detailed, as well as ADC values established by investigators.ResultsADC values for presence of air-fluid levels, mucosal thickening and mucous retention cyst were respectively: 1.99 x 10-3 mm2/s; 1.83 x 10-3 mm2/s; 2.05 x 10-3 mm2/s.ConclusionsIt was observed that apparent diffusion coefficient values from the inflammatory lesions described in this report were different and apparent diffusion coefficient may be useful in the differentiation of these maxillary sinus alterations. Further larger sample investigations considering apparent diffusion coefficient values focusing in inflammatory lesions are recommended. The lack of studies considering the use of diffusion-weighted magnetic resonance imaging on inflammatory diseases diagnostic was the major limitation to the literature review.
| The Canalis Sinuosus (CS) is known as an anatomical variation of anterior superior alveolar nerve being a neurovascular bundle. Frequently, the anterior maxillary region receives surgical interventions of different specialties. The knowledge concerning anatomical structures in this region is crucial to reach predictable and safe surgical procedures. The overlapping of anatomical structures in conventional imaging examinations has a limit in observing neurovascular canal, such as the CS. Thus, Cone Beam Computed Tomography (CBCT) images may give a great support in preoperative planning, since it allows the three-dimensional reconstruction of the anatomical details of its structures. In this report, the author describes an implant rehabilitation that may have possibly injured the anterior superior alveolar nerve. RESUMO | Canal Sinuoso e procedimentos radiográficos na região anterior da maxila • O canal sinuoso (CS) é conhecido como uma variação anatômica do nervo alveolar anterior superior, sendo um canal de feixe vásculo-nervoso. Frequentemente a região anterior da maxila recebe intervenções cirúrgicas de diferentes especialidades. O conhecimento a respeito das estruturas anatômicas presentes nessa região é de suma importância para se alcançar procedimentos cirúrgicos mais seguros e previsíveis. A sobreposição de estruturas anatômicas nos exames de imagens convencionais é uma limitação para se observar o canal neuro vascular como o CS. Assim, as imagens de Tomografia Computadorizada por Feixe Cônico (TCFC) são de grande auxílio no planejamento pré-cirúrgico, pois permitem avaliar os detalhes das estruturas anatômicas em três dimensões. Neste estudo, os autores relatam um caso de reabilitação por implante que poderia ter lesionado o nervo alveolar superior anterior.
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