The use of high resolution magnetic resonance on 3.0-T system in solid/multicystic ameloblastoma surgical planning. Case report.

OBJECTIVES

The solid/multicystic ameloblastoma is a slowly growing, locally invasive epithelial odontogenic tumour. In 80% of cases this lesion occurs in the mandible, mainly in the posterior region, and it is characterized by the involvement of the inferior alveolar nerve. A panoramic radiograph of a 43-year-old man with chronic deep pain in the posterior area of the mandible showed a multilocular radiolucent lesion with scalloped borders in the left mandibular ramus. After the execution of a computed tomography of the jaws, to accurately determine the limits of the lesion and the relationship with the the inferior alveolar nerve, the magnetic resonance imaging was used.

METHODS

The spatial relationship between the lesion and the inferior alveolar nerve was defined comparing different imaging methods: panoramic radiography, computed tomography and magnetic resonance imaging. T1-weighted fast spoiled gradient-recalled echo, T1-weighted fast imaging employing steady-state acquisition, T2-weighted interactive decomposition of water and fat with echo asymmetry least-squares estimation and Diffusion weighted imaging acquisition sequences were used on a 3.0 T unit.

RESULTS

Regarding the inferior alveolar nerve course and its spatial relationship with the mandibular lesion, magnetic resonance imaging provided more detailed spatial and structural information than other imaging methods.

CONCLUSION

The described acquisition sequences allowed us to highlight the diagnostic efficacy of the magnetic resonance in the morpho-structural characterization of a maxillofacial lesion and showed the importance of this imaging method as an additional technique to the computerized tomography in the maxillofacial surgical planning, resulting in a risk reduction of the inferior alveolar nerve surgical injury.

KEY WORDS: Ameloblastoma, Mandibular Nerve, Magnetic Resonance Imaging, Tomography X-Ray Computed.