Study Of Radiological Features In Ateriovenous Malformaions Of The Jaws

Purpose:The purposes of our study was to summarize the radiological findings ofarteriovenous malformation (AVMs) of the jaws, to evaluate the diagnostic value ofpanoramic radiography, computed tomography (CT) and magnetic resonance imaging(MRI)of AVMs of the jaws.Materials and methods:A retrospective analysis of124patients who were suspected as AVM of the jaws from2004to2014.119patients were confirmed AVM by digital substraction angiogram (DSA)or pathological examination,3patients were diagnosed as tumors,2patients were venousmalformation, CT scans was available for57cases (17cases were maxilla and40caseswere mandible), panoramic radiography was available for23cases (3cases were maxillaand20cases were mandible), MRI was available for14cases (6cases were maxilla and8cases were mandible). Combine DSA and pathological examination, summarize theclinical manifestation and radiological findings of AVMs of the jaws. The location and theshape of the lesions, inner and adjacent structures, the margins of the lesions, the densityand signal intensity of the lesions were analyzed together with DSA manifestation.Meanwhile, for maxilla, we measure the pterygopalatine fossa/pterygopalatine canal/greatpalatine foramen and compare two side, Application of two independent samples t-test tocompare differences between two sets of values by Stata12.0. For mandible, bilateralcomparison of the width of the inferior alveolar nerve canal and mental foramen, applications wilconxon rank sum test to compare differences between two sets of valuesResults:①The major complaint of108patients with AVMs of the jaws include repeatedbleeding, emergency controllable bleeding, swelling of the face, pulsatile soft mass,anesthesia or asymptomatic. Physical examination mainly revealed a thrill, an increasedtemperature or ulcer of the skin.②The panoramic radiography of AVM of maxilla lack of characteristic features, OnCT scan had variable appearance such as intraosseous osteolytic expansion withsurrounding soft tissue involvement or ground glass appearance, elevated maxillary sinus,coarse trabeculae, widened external carotid artery or other draining veins and displayed inadvance, resorption displacement of roots, widened pterygopalatine fossa/pterygopalatinecanal/great palatine foramen. Application of two independent samples t-test to comparedifferences between two sets of values, it is believed that pterygopalatine fossa/pterygopalatine canal/great palatine foramen obvious widened. On MRI scan, maxillaAVM revealed signal flow voids both in T1WI and T2WI or an enhanced mass.③The high spatial resolution of panoramic radiography helps to show the widenedinferior alveolar nerve canal and the relationship between teeth and lesions, Theradiological findings of AVMs of mandible on enhanced CT have some characteristicfeatures, such as intraosseous osteolytic expansion, the widened inferior alveolar nervecanal and mental foramen, the tortuous vessels, coarse trabeculae, bone density ormorphological abnormalities, displacement of inferior alveolar nerve canal, soft tissueinvolvement, root resorption or displacement, widened external carotid artery or otherdraining veins and displayed in advance. Bilateral comparison of the width of the inferioralveolar nerve canal and mental foramen, applications wilconxon rank sum test to comparedifferences between two sets of values, it is believed that the inferior alveolar nerve canaland mental foramen obvious widened. MRI features was signal flow voids both in T1WIand T2WI. Conclusion:AVMs of jaw are very rare, improper treatment may lead to remarkable hemorrhageor fatal outcomes, dentists should be aware of the clinical and radiological features. Thepanoramic radiography may be the initial inspection methods of AVMs of jaws. It help toshow the relationship between teeth and lesions, meanwhile the widened inferior alveolarnerve canal highly suggest a AWM. Both CT and MRI provide great diagnostic method,enhanced CT is more audiovisual and sensitive than MRI. Because of the anatomicalfactors, there exist some different radiological appearances between maxilla and mandibleAVMs, meanwhile, some atypical findings should be known by radiologist and dentist.