Osteosarcoma of the temporomandibular joint: report of 2 cases.

The aim of this article is to report 2 cases of osteosarcoma of the mandibular condyle, a rare pathological condition, and to emphasize and discuss the usefulness of different imaging modalities in the diagnosis and evaluation of osteosarcoma of the temporomandibular joint. In our assessment of the different imaging modalities, we found that 2-dimensional computed tomograms provide excellent detection of tumor calcification, cortical involvement, and in most instances, soft tissue and intramedullary extension, whereas 3-dimensional computed tomography vascular protocol can help to define the extension of the lesion, improving the visualization of the lesion's relationship to the adjacent anatomical structures. Magnetic resonance imaging is more effective in demonstrating the intramedullary and extraosseous tumor components on T2 weighted images. Because metastasis from body tumors to the maxillofacial region occurs occasionally, it is useful to examine the oral cavity when symptoms first appear and devote special attention to the subtle changes that may indicate early metastatic involvement.

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation.

OBJECTIVE: The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. STUDY DESIGN: The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. RESULTS: The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CONCLUSION: CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.

Topographic metabolic map of head and neck squamous cell carcinoma using 18F-FDG PET and CT image fusion.

OBJECTIVE: To propose a methodologic approach to evaluate head and neck tumors in order to identify and distinguish areas of higher metabolic activity inside the lesion. STUDY DESIGN: The sample consisted of 17 patients with squamous cell carcinoma of the head and neck. Images were simultaneously acquired using a nondedicated PET-CT device and an independent workstation with ENTEGRA 2 NT software to generate the image fusion between PET and CT. Sites of higher metabolic activity inside the tumor were classified as centric or eccentric according to their relative location to the lesion center. RESULTS: Seventy-seven percent (n=13) of the patients presented the site of higher metabolic activity at the center of lesion, and in 23% (n=4) the uptake of the tracer was increased at the periphery of the lesion. CONCLUSIONS: This technique gave a realistic view of the functional metabolism, locating the anatomical tumor area and helping in future treatment planning.