Application Study Of MRI In Interventional Ethanol Sclerotherapy In Treating Cystic Lesions Of The Jaws

Objective: To select cases that are fit for the interventional ethanolsclerotherapy. To analyze and evaluate the MR diffusion-weightedimaging (MR-DWI) features of ameloblastoma and keratocysticodontogenic tumor (KCOT) and to assess the performance of apparentdiffusion coefficients (ADCs) in the differential diagnosis ofameloblastoma and KCOT. To investigate the changes between MRI andCT before and after the treatment of interventional ethanol sclerotherapyin treating cystic lesions of the jaws.Method:20patients with cystic lesions of jaws were checked byPanoramic X-Ray, CT, MRI and smears of cyst fluid. We retrospectivelyobserved18patients with ameloblastoma and11patients with KCOT,which underwent both conventional MR imaging and MR-DWI. In theMR-DW images, the apparent diffusion coefficient (ADC) mean valuewas taken from b=0s/mm2and1000s/mm2. The data was analyzed usingSPSS16.0software package for Mann-whitney U-test. This was a reviewof14patients treated with absolute alcohol sclerotherapy for cysticlesions of jaws at a single institution. Treatment response was evaluated radiographically and clinically. After using the software MIM6.2.3foranalyzing CT got before and after absolute alcohol sclerotherapy, thevolume of the cystic lesions was measured to evaluate the effects of thetreatment. We retrospectively observed the MR imaging of10patientswith cystic lesions of jaw, which underwent the treatment ofinterventional ethanol sclerotherapy. In the MR-DW images, the apparentdiffusion coefficient (ADC) mean value was taken from b=0s/mm2and1000s/mm2. To observe the effects of the treatment.Results: Six cases with cystic lesions of the jaws were excluded fromthe interventional ethanol sclerotherapy. The cystic areas ofameloblastoma (n=18) showed free diffusion with a mean ADC2.121±0.26×10-3mm2/s, whereas the solid areas showed restricted diffusionwith a mean ADC value of value of1.363±0.20×10-3mm2s-1. KCOT(n=11) showed restricted diffusion with a mean ADC value of0.931±0.17×10-3mm2s-1。There was significant difference between the cysticareas of the two lesions (P＜0.001, Mann-Whitney U-test). The cut-offwith which ameloblastoma and KCOT were optimally differentiated was1.5×10-3mm2s-1, which yielded100%sensitivity and100%specificity.The volume of the cystic lesions before the treatment of interventionalethanol sclerotherapy was significantly smaller than that after thetreatment (P<0.05, paired t-test). The cystic lesions before the treatmentof interventional ethanol sclerotherapy had a mean ADC1.831±0.23× 10-3mm2/s, while the cystic lesions after the treatment had a mean ADC1.792±0.25×10-3mm2/s. No significant difference was found betweenthe two groups (P<0.05, paired t-test).Conclusions: MRI has a good value in choosing cases with cysticlesions of jaws which are suit for the interventional ethanol sclerotherapy.It’s an effective way to treat cystic lesions of the jaws using interventionalethanol sclerotherapy.