Assessment of Acute Osteomyelitis in the Mandible using Diffusion Weighted MR Imaging

Abstract

Osteomyelitis of the mandible is most commonly caused by bacterial infections (1). In adults, osteomyelitis is usually an acute or chronic infection that develops follow to an open wound to the bone and around soft tissue. Acute osteomyelitis is caused by hematogenous spread or direct inoculation, and bacterial growth within the bone induces an acute suppurative response. Chronic osteomyelitis represents bone destruction and sequestrum formation. It is usually treated with medicine and surgical cleaning. Although, it can persist lengthening for years with frequent treatment failure or relapse (2, 3). Radiological imaging techniques play an essential part in the early diagnosis and followup of skeletal inflammatory conditions. The importance of radiology and imaging in the cases of osteomyelitis of the jaws is well documented in the past literature. It has also been reported that magnetic resonance imaging (MRI) is helpful in the diagnosis of mandibular osteomyelitis (4-9). DWI make use of the brownian motion of water protons in biological tissue. This movement mirrors the tissue unique diffusion capacity and can be used to characterize the organization. This movement brings results that dispersion phase of diffusion hyposensitized protons of water along the applied diffusion gradients and consecutively to a loss of signal on DWI. This signal loss is proportional to the diffusion intensity used and the mobility of water protons (10-12). DWI data based on MRI can be used for determination of quantitative diffusion values such as the ADC. ADC is a parameter for the amount of diffusion (proton of water) in the tissue. Many studies have reported evaluation to ADC values in musculoskeletal region such as normal bone marrow, osteoporosis, osteomyelitis, malignancy and trauma (13-15). However, there was a little attention to evaluate osteomyelitis of the mandible using DWI. The purpose of the present study was to investigate the mean of ADC values in the mandibular bone marrow with acute osteomyelitis and normal subject.

Optimizing diagnosis and surgical decisions for chronic osteomyelitis through radiomics in the precision medicine era

“…Although previous studies have evaluated osteomyelitis using MRI (Oda et al, 2018;Iwasaki and Muraoka, 2020;Massel et al, 2021), there is limited research on the application of MRI radiomics in assessing chronic osteomyelitis. Therefore, further research and exploration in this field are valuable.…”