The imaging evaluation of jaw lesions may range from a combination of intraoral and panoramic radiography to CT, MRI, US, and/or scintigraphy, depending on the size, location, margins, and behavior of the lesion. For small well-defined lesions occurring in the jaws, standard dental radiography may be adequate to
characterize the lesion and permitting the development of a differential diagnosis prior to confirmation by biopsy.
However, if the jaw lesion is large, causes jaw expansion, has indistinct or irregular margins, or appears to be a tumor originating in soft tissues, additional information is usually needed either before or after biopsy, to determine the extent of the lesion and its relationship to adjacent tissues. If the lesion is malignant, evaluation for metastasis is necessary. Although CT is frequently used to examine the lymph nodes of the neck, recent reports have suggested that US can reliably distinguish metastatic nodes from reactive and normal nodes.
In some cases, CT and MRI may be of more value in planning the treatment than in making the diagnosis since appropriate treatment is predicated on knowing the full extent of the lesion, including any invasion of adjacent structures (Figure 3-18).
However, if the jaw lesion is large, causes jaw expansion, has indistinct or irregular margins, or appears to be a tumor originating in soft tissues, additional information is usually needed either before or after biopsy, to determine the extent of the lesion and its relationship to adjacent tissues. If the lesion is malignant, evaluation for metastasis is necessary. Although CT is frequently used to examine the lymph nodes of the neck, recent reports have suggested that US can reliably distinguish metastatic nodes from reactive and normal nodes.
In some cases, CT and MRI may be of more value in planning the treatment than in making the diagnosis since appropriate treatment is predicated on knowing the full extent of the lesion, including any invasion of adjacent structures (Figure 3-18).