• 제목/요약/키워드: Cortical perforation

검색결과 38건 처리시간 0.027초

섬유성 이형성증의 바늘구멍 골스캔 소견 (Pinhole Bone Scintigraphic Manifestation of Fibrous Dysplasia)

  • 백지희;이성용;김성훈;정용안;김범수;송하헌;정수교;강시원;박용휘;신경섭
    • 대한핵의학회지
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    • 제31권4호
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    • pp.452-458
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    • 1997
  • 저자들은 섬유성 이형성증으로 진단받은 14명 환자의 16병변에서 단순 X-선사진의 소견에 따른 부위별 방사능 집적 정도를 알아보고 그 의의를 평가하기 위해 바늘구멍 골스캔과 단순 X-선사진 소견을 후향적으로 분석하여 비교하여 보았다. 10병변은 수술하여 조직학적으로 확진되었고, 6병변은 방사선학적으로 진단 받았다. 평균연령은 41.1세이며, 두 검사간의 간격은 평균 1.1일이었다. 병소의 위치는 늑골 7예, 골반골 4예, 쇄골 1예, 대퇴골 2예, 장골 1예, 상완골 1예였다. 바늘구멍골스캔 소견상 중심부에서 1+로 정상 방사능 집적을 보인예는 6예(방사선투과성 병변 5예, 간유리모양 병변 1예)이고, 2+로 중등도로 증가된 방사능 집적을 보인 경우는 7예(방사선투과성 병변 4예, 간유리모양 병변 3예)이며 3+로 현저히 증가된 경우는 3예(간유리모양 병변 1예, 경화성 병변 2예)가 있었다. 16예 중 15예에서 주변부 병소에 한 군데 이상의 증가된 방사능 집적이 불규칙한 환상이나 결절모양으로 나타났는데, 2+의 중등도 방사능 집적이 경화성테두리 5예와 비가시성 피질 1예에서, 그리고 3+의 현저한 방사능 집적증가는 격막과 피질천공을 보인 모든 예(7예, 8예)에서, 그리고 비가시성 피질 9예 중 8예에서 나타났다. 16예 중 1예는 중심부와 주변부 병소가 균일한 2+의 집적증가를 보였다. 바늘구멍 골스캔상 섬유성 이형성증의 방사선투과성병변은 이제까지 보고된 것과는 다르게 많은 예에서 인접 정상골과 비슷한 집적을 보였다. 또한, 격막, 피질골절 또는 비가시성 피질 등의 소견을 보이는 부분에 방사능 집적이 현저히 증가되어 주변부의 불규칙한 환상 또는 결절모양의 방사능 집적형태를 보였으며, 이들 병소는 골대사가 활발한 부위로 생각된다. 이와 같은 골의 섬유성 이형성증의 바늘구멍 골스캔 소견을 분석함으로써 부위별 활성도를 평가하여 진단, 예후 추정 및 치료방침을 결정하는데 유용하리라 사료된다.

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Pedicle Morphometry for Thoracic Screw Fixation in Ethnic Koreans : Radiological Assessment Using Computed Tomographic Myelography

  • Choi, Yang-Soo;Kim, Young-Jin;Yi, Hyeong-Joong;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.317-321
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    • 2009
  • Objective : In the thoracic spine, insertion of a pedicle screw is annoying due to small pedicle size and wide morphological variation between different levels of the spine and between individuals. The aim of our study was to analyze radiologic parameters of the pedicle morphometry from T1 to T8 using computed tomographic myelography (CTM) in Korean population. Methods : For evaluation of the thoracic pedicle morphometry, the authors prospectively analyzed a consecutive series of 26 patients with stable thoracic spines. With the consent of patients, thoracic CTM were performed, from T1 to T8. We calculated the transverse outer diameters and the transverse angles of the pedicle, distance from the cord to the inner cortical wall of the pedicle, and distance from the cord to the dura. Results : Transverse outer pedicle diameter was widest at T1 ($7.66{\pm}2.14\;mm$) and narrowest at T4 ($4.38{\pm}1.55\;mm$). Transverse pedicle angle was widest at T1 ($30.2{\pm}12.0^{\circ}$ and it became less than $9.0^{\circ}$ below T6 level. Theoretical safety zone of the medial perforation of the pedicle screw, namely, distance from the cord to inner cortical wall of the pedicle was more than 4.5 mm. Conclusion : Based on this study, we suggest that the current pedicle screw system is not always suitable for Korean patients. Computed tomography is required before performing a transpedicular screw fixation at the thoracic levels.

Deep Neck Space Infection Caused by Keratocystic Odontogenic Tumor

  • Oh, Ji-Su;Kim, Su-Gwan;You, Jae-Seek;Min, Hong-Gi;Kim, Ji-Won;Kim, Eun-Sik;Kim, Cheol-Man;Lim, Kyung-Seop
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제36권2호
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    • pp.73-77
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    • 2014
  • Keratocystic odontogenic tumor (KCOT) is a benign cystic intraosseous tumor of odontogenic origin. An infection of a KCOT is not common because KCOT is a benign developmental neoplasm. Moreover, a severe deep neck space infection with compromised airway caused by infected KCOT is rare. This report presents a 60-year-old male patient with a severe deep neck space infection related to an infected KCOT due to cortical bone perforation and rupture of the exudate. Treatment of the deep neck space infection and KCOT are reported.

좌측 하악 구치부에 발생한 재발성 백악모세포종의 치험례 (RECURRENT CEMENTOBLASTOMA IN LEFT MANDIBLE : A CASE REPORT)

  • 정준호;김여갑;이백수;권용대;최병준;김영란
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권4호
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    • pp.349-352
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    • 2009
  • Cementoblastoma is a benign ectomesenchymal odontogenic neoplasm that forms a mass of cementum or cementum-like tissue continuous with the tooth root. Cementoblastoma represents 1% to 6.2% of all odontogenic tumors, and occurs more than 75% arise in the mandible, with most cases arising in the molar and premolar regions. About 75% arises before the age of 30. Radiographically, it appears as a radiopaque mass with a thin radiolucent rim attached to the roots of a tooth. The recurrence rate is 37% in the current study and cortical expansion and perforation of the cortex are common findings in lesions that subsequently recurred. It is apparent that recurrence rate depends largely on the completeness of removal than any other factor. Here we present a 20 year old, female case of an unusual multiple recurrent cementoblastoma around a previous lesion which had been surgically excised 2 years ago.

저작근 공간에서 재발된 치성각화낭 (Recurrent odontogenic keratocyst within the masticatory space)

  • 임수연;허경회;이원진;최현배;최순철
    • Imaging Science in Dentistry
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    • 제38권2호
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    • pp.117-120
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    • 2008
  • The odontogenic keratocyst (OKC) is a developmental odontogenic cyst typically occurring in the jaws. Since the first description of OKC was published in 1956, the lesion has been of particular interest because of its specific histopathologic features, high recurrence rate, and aggressive behavior. Recurrences most commonly arise within bone at the site of the original cyst. However, as lining cells may find their way into surrounding tissues either from implantation during surgery or from cortical perforation recurrences may arise at a distance from the original cyst. Here, we report a rare case of recurrent OKC which was first developed in mandible and recurred within the masticatory space.

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Risk factors for postoperative infection of odontogenic cysts associated with mandibular third molar

  • Kim, Jin-woo;On, Do-hyun;Cho, Jin-yong;Ryu, Jaeyoung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.4.1-4.4
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    • 2020
  • Background: Odontogenic cysts associated with lower third molar are common. The prognosis for surgical treatment is relatively good. However, postoperative infection discourages the clinicians. Hence, we would like to investigate the factors associated with infection after surgical treatment of cysts associated with the mandibular third molar. Methods: We retrospectively reviewed the medical and radiographic records of 81 patients who were diagnosed with dentigerous cyst or odontogenic keratocyst and underwent cyst enucleation. The factors affecting postoperative infection were divided into host factor, treatment factor, and cystic lesion factor. To identify the factors associated with postoperative infection, we attempted to find out the variables with significant differences between the groups with and without infection. Results: A total of 81 patients (64 male and 17 female) were enrolled in this study. There was no statistical relationship about the postoperative infection between all variables (gender, smoking, diabetes mellitus, age, bone grafting, related tooth extraction, previous marsupialization or decompression, type of antibiotics, cortical perforation associated with cystic lesion, preoperative infection, preoperative cyst size). Conclusions: The results of this study suggest that it is not necessary to avoid bone grafts that are concerned about postoperative infection.

Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review

  • Tahmasbi-Arashlow, Mehrnaz;Patel, Paras B.;Nair, Madhu K.;Liang, Hui;Cheng, Yi-Shing Lisa
    • Imaging Science in Dentistry
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    • 제52권2호
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    • pp.123-131
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    • 2022
  • Purpose: The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. Materials and Methods: This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients' demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). Results: In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion's size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. Conclusion: CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.

A Case of Pentastomiasis at the Left Maxilla Bone in a Patient with Thyroid Cancer

  • Cho, Eunae Sandra;Jung, Seung Wook;Jung, Hwi-Dong;Lee, In Yong;Yong, Tai-Soon;Jeong, Su Jin;Kim, Hyun Sil
    • Parasites, Hosts and Diseases
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    • 제55권4호
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    • pp.433-437
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    • 2017
  • Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

하악 우측 골체부에서, 동일한 병소 내에 발생한 골내성 거대세포 육아종과 백아질 섬유종의 치험례 (CENTRAL GIANT CELL GRANULOMA AND CEMENTIFYING FIBROMA OCCURRING IN THE SAME LESION OF RIGHT MANDIBULAR BODY : A CASE REPORT)

  • 김일규;하수용;이성준;주영채
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권2호
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    • pp.177-184
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    • 1991
  • 저자등은, 치온부의 종괴를 주소로 내원한 10세 남아의 하악 우측 골체부에서, 동일한 부위에 함께 발생한 골내성 거내세포 육아종과 백아질 섬유종으로 진단된 증례로, 수술시 비교적 작은 크기의 백아질 섬유종은 골내성 거대세포 육아종과 비교적 경계가 잘 지워져 있었고, 두 병소의 발생기원이 서로 다른 점으로 미루어 이들 두 병소는 서로 독립하여 동일 부위에 발생한 것으로 사료되며, 임상적인 관점에서, 거대세포 육아종은 어린나이에 비교적 병소가 크고, 제1 제2 대구치의 치근 흡수 및 피판의 천공 소견을 보여 aggressive type으로 판단되어, 소파술과 전기 소작술을 이용하여 두 병소를 만족스럽게 치험하고, 1년이 지난 현재까지 수술에 따른 후유증이나 재발의 소견을 나타내지 않기에 문헌고찰과 함께 보고하는 바이다.

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거골에 발생한 골육종 - 증례 보고 - (Osteosarcoma of the Talus - Case Report -)

  • 김병석;임호영;조재현;김태홍;이기범
    • 대한골관절종양학회지
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    • 제8권3호
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    • pp.90-95
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    • 2002
  • 42세 남자 환자가 우측 족관절부에 4개월 동안 증가하는 동통 및 종괴를 주소로 내원하였다. 단순 방사선 소견 및 전산화 단층 촬영 소견상 우측 거골 경부의 골내부 및 피질골 파괴소견을 보였다. 병리소견은 고악성도의 골형성 골육종이었다. 두 사이클의 수술전 항암치료에도 불구하고, 족관절부의 종괴는 커졌고 폐전이로 진행되었다. 원발 병소에 대하여 슬관절하 절단, 폐전이에 대하여 쐐기모양 폐 절제술을 실시하였고 수술후 항암치료를 시행하였으나 수술후 10개월에 폐전이로 환자는 사망하였다.

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