Dental MRI of Oral Soft-Tissue Tumors—Optimized Use of Black Bone MRI Sequences and a 15-Channel Mandibular Coil

Abstract

Soft-tissue lesions in the oral cavity, one of the most common sites for tumors and tumor-like lesions, can be challenging to diagnose and treat due to the wide spectrum from benign indolent to invasive malignant lesions. We report an abnormally large, rapidly growing hyperplastic lesion originating from the buccal mucosa in a 28-year-old male patient. Clinical examination revealed a well-circumscribed, smooth-surfaced, pinkish nodular lesion measuring 2.3 × 2 cm, which suggested the differential diagnosis of irritation fibroma, pyogenic granuloma, oral lipoma, and other benign or malignant neoplasms such as hemangioma, non-Hodgkin’s lymphoma, or metastases to the oral cavity. Dental MRI using a 15-channel mandibular coil was performed to improve perioperative radiological and surgical management, avoiding adverse intraoperative events and misdiagnosis of vascular malformations, especially hemangiomas. Black bone MRI protocols such as STIR (short-tau inversion recovery) and DESS (double-echo steady-state) were used for high-resolution radiation-free imaging. Radiologic findings supported the suspected diagnosis of an irritation fibroma and ruled out any further head and neck lesions, therefore complete surgical resection was performed. Histology confirmed the tentative diagnosis. This article evaluates the use of this novel technique for MR diagnosis in the perioperative management of soft-tissue tumors in oral and maxillofacial surgery.

MR-orthopantomography in operative dentistry and oral and maxillofacial surgery: a proof of concept study

“…dental implants or dentures 18 . Given the recent advances in sequences and innovations such as intraoral coils 19 or mandibular coils that might allow faster imaging 20 , dental MRI represents a promising option with great potential to be established as a diagnostic tool in various disciplines of operative dentistry and oral and maxillofacial surgery.…”

Appearance of nasopalatine duct cysts on dental magnetic resonance imaging using a mandibular coil: Two case reports with a literature review

“…In the cases presented herein, dental MRI was performed with a novel mandibular coil to produce high-resolution and high-contrast imaging of the oral cavity and to avoid repetitive radiation exposure to patients. 9 There have been few reports documenting the MRI appearance of NPDCs with conventional MRI protocols. 12 13 14 However, recently implemented promising indication-specific MRI protocols allow the simultaneous visualization of hard and soft tissues, with better detection of the smallest soft tissue tumors due to excellent soft tissue contrast.…”

“… 8 In this regard, several MRI protocols modified for the oral cavity using specific mandibular coils have allowed better visualization of the relative location of space-occupying lesions. 9 However, the MRI features of NPDCs have rarely been reported. With the ongoing implementation of dental MRI protocols in everyday clinical care, the diagnostic features of NPDCs need to be described, and clinicians should be familiar with these features to improve case-specific patient management.…”

Proposal for a Paradigm Shift in Personalized Medicine for Patients with a Maxillary Edentulous Jaw by ENT Specialist and Dentist Cooperation

“…Therefore, we recommend that ENT specialists evaluate both anatomic variations and maxillary pathologies using paranasal CT during the COVID-19 pandemic because paranasal CT findings correspond to those of a nasal endoscopy [ 13 ]. Promising alternative diagnostic evaluations for pathologies in the maxillary sinus are low-dose cone-beam CT and dental magnetic resonance imaging (MRI) using the black-bone MRI sequence [ 33 , 34 ]. Because anatomic variations that can cause stenosis of maxillary drainage pathways in addition to maxillary sinus pathologies should be evaluated, the imaging range should involve the natural ostium of the maxillary sinus.…”