Malignant tumors and chronic infections in the masticator space: preliminary assessment with in vivo single-voxel 1H-MR spectroscopy.
OBJECTIVE
Differential diagnosis between malignant tumors and chronic infections in the masticator space remains challenging. The purpose of the study was to categorize various changes of both lesions by using single-voxel 1H-MR spectroscopy.


METHODS
Twenty-four masticator space lesions, 7 chronic infections, and 17 malignant tumors were assessed with 1H-MR spectroscopy before treatment procedures. The MR spectroscopic findings were compared with surgical and histopathologic results. Localization technique for 1H-MR spectroscopy was made by a point-resolved spectroscopy sequence at an echo time of 144 ms. Choline (Cho) signals (identified at 3.2 ppm) and Cho signal intensity-to-noise ratio (Cho/noise) were considered as evaluating criteria.


RESULTS
All the lesions were found with 3 1H-MR spectroscopic types: type 1, lesions without Cho signals (3 chronic infections); type 2, lesions with Cho signals and Cho/noise ratio <3 (4 chronic infections and 4 malignant tumors); and type 3, lesions with Cho signals and Cho/noise ratio >3 (13 malignant tumors). The mean +/- SD of the Cho/noise ratio between chronic infections and malignant tumors was 2.31 +/- 0.19 and 5.76 +/- 3.29 (P < .01), respectively.


CONCLUSIONS
In vivo single-voxel 1H-MR spectroscopy may be helpful in the assessment of masticator space lesions. Differences of Cho signals and Cho/noise ratios between malignant tumors and chronic infections provide valuable information in the differentiation of these 2 lesions.
Yu
Q
Q
Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China. yuqiang6155@163.com
Yang
J
J
Wang
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007239:Infections / Q000175:diagnosis*; D007573:Jaw Neoplasms / Q000175:diagnosis; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008409:Mastication; D008444:Maxillary Sinus Neoplasms / Q000175:diagnosis; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis*; D009062:Mouth Neoplasms / Q000175:diagnosis*; D012468:Salivary Gland Neoplasms / Q000175:diagnosis; D012680:Sensitivity and Specificity