Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes
Abstract Objectives To compare and correlate bone edema volume detected by 3D-short-tau-inversion-recovery (STIR) sequence to osseous decay detected by a T1-based sequence and conventional panoramic radiography (OPT). Materials and methods Patients with clinical evidence of apical periodontitis were...
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2025-01-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-025-01903-z |
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| author | Alexander W. Marka Monika Probst Tobias Greve Nicolas Lenhart Niklas Graf Florian Probst Gustav Andreisek Thomas Frauenfelder Matthias Folwaczny Egon Burian |
| author_facet | Alexander W. Marka Monika Probst Tobias Greve Nicolas Lenhart Niklas Graf Florian Probst Gustav Andreisek Thomas Frauenfelder Matthias Folwaczny Egon Burian |
| author_sort | Alexander W. Marka |
| collection | DOAJ |
| description | Abstract Objectives To compare and correlate bone edema volume detected by 3D-short-tau-inversion-recovery (STIR) sequence to osseous decay detected by a T1-based sequence and conventional panoramic radiography (OPT). Materials and methods Patients with clinical evidence of apical periodontitis were included retrospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR and a 3D-T1 gradient echo sequence. Bone edema was visualized using the 3D-STIR sequence and periapical hard tissue changes were evaluated using the 3D-T1 sequence. Lesions were segmented and volumes were calculated for bone edema and structural decay. OPTs were assessed for corresponding periapical radiolucencies using the periapical index (PAI). Results Of the 42 patients of the initial cohort 21 patients with 38 periapical lesions were included in the analysis (mean age 57.2 ± 13.8 years, 9 women). Reactive bone edema was detected on MRI in 23 periapical lesions with corresponding radiolucency on OPT. Fifteen periapical lesions were detected only in the STIR sequence. The volume of edema measured in the STIR was significantly larger in OPT-positive lesions (mean: STIR (OPT+) 207.3 ± 191.1 mm³) compared to OPT-negative lesions (mean: STIR (OPT−) 29.5 ± 34.2 mm³, p < 0.001). The ROC curve analysis demonstrated that Volume T1 (0.905, p < 0.01) and Volume STIR (0.857, p < 0.01) measurements have strong diagnostic performance for distinguishing OPT-positive from OPT-negative lesions. Conclusion Clinically symptom-free patients without pathologic changes in OPT can show signs of inflammation within the periapical bone. Bone edema volume visualized by STIR sequence exceeds bone architecture changes indicated in T1-based imaging and might precede osteolysis in dental radiography. Critical relevance statement These results show that subtle intraosseous inflammation within the periapical tissue might remain undetected by conventional dental radiography and T1-based sequences. This emphasizes the potential of MRI in secondary prevention in dentistry. Key Points Conventional panoramic radiography (OPT) may show only delayed findings of pathological periapical changes. MRI detected bone edema in 23 radiolucent lesions on OPT. MRI revealed 15 lesions only visible with STIR sequences. STIR sequences showed bone inflammation undetectable by conventional radiography or T1 imaging. MRI offers diagnostic advantages for early dental pathology detection. Graphical Abstract |
| format | Article |
| id | doaj-art-9973c7df71a248f68a423c45483e9e84 |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-9973c7df71a248f68a423c45483e9e842025-02-02T12:27:54ZengSpringerOpenInsights into Imaging1869-41012025-01-011611910.1186/s13244-025-01903-zPeriapical bone edema volume in 3D MRI is positively correlated with bone architecture changesAlexander W. Marka0Monika Probst1Tobias Greve2Nicolas Lenhart3Niklas Graf4Florian Probst5Gustav Andreisek6Thomas Frauenfelder7Matthias Folwaczny8Egon Burian9Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Neurosurgery, LMU University Hospital, LMU MunichDepartment of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Oral and Maxillofacial Surgery, Helios Clinic Munich West, Teaching Hospital of the Ludwig-Maximilians-University of MunichDepartment of Oral and Maxillofacial Surgery, University of MunichDepartment of Diagnostic and Interventional Radiology, Cantonal Hospital FrauenfeldDiagnostic and Interventional Radiology, University Hospital of Zurich, University ZurichDepartment of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-UniversityDiagnostic and Interventional Radiology, University Hospital of Zurich, University ZurichAbstract Objectives To compare and correlate bone edema volume detected by 3D-short-tau-inversion-recovery (STIR) sequence to osseous decay detected by a T1-based sequence and conventional panoramic radiography (OPT). Materials and methods Patients with clinical evidence of apical periodontitis were included retrospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR and a 3D-T1 gradient echo sequence. Bone edema was visualized using the 3D-STIR sequence and periapical hard tissue changes were evaluated using the 3D-T1 sequence. Lesions were segmented and volumes were calculated for bone edema and structural decay. OPTs were assessed for corresponding periapical radiolucencies using the periapical index (PAI). Results Of the 42 patients of the initial cohort 21 patients with 38 periapical lesions were included in the analysis (mean age 57.2 ± 13.8 years, 9 women). Reactive bone edema was detected on MRI in 23 periapical lesions with corresponding radiolucency on OPT. Fifteen periapical lesions were detected only in the STIR sequence. The volume of edema measured in the STIR was significantly larger in OPT-positive lesions (mean: STIR (OPT+) 207.3 ± 191.1 mm³) compared to OPT-negative lesions (mean: STIR (OPT−) 29.5 ± 34.2 mm³, p < 0.001). The ROC curve analysis demonstrated that Volume T1 (0.905, p < 0.01) and Volume STIR (0.857, p < 0.01) measurements have strong diagnostic performance for distinguishing OPT-positive from OPT-negative lesions. Conclusion Clinically symptom-free patients without pathologic changes in OPT can show signs of inflammation within the periapical bone. Bone edema volume visualized by STIR sequence exceeds bone architecture changes indicated in T1-based imaging and might precede osteolysis in dental radiography. Critical relevance statement These results show that subtle intraosseous inflammation within the periapical tissue might remain undetected by conventional dental radiography and T1-based sequences. This emphasizes the potential of MRI in secondary prevention in dentistry. Key Points Conventional panoramic radiography (OPT) may show only delayed findings of pathological periapical changes. MRI detected bone edema in 23 radiolucent lesions on OPT. MRI revealed 15 lesions only visible with STIR sequences. STIR sequences showed bone inflammation undetectable by conventional radiography or T1 imaging. MRI offers diagnostic advantages for early dental pathology detection. Graphical Abstracthttps://doi.org/10.1186/s13244-025-01903-zMagnetic resonance imagingPeriapical osteolysisDentistryDental radiographs |
| spellingShingle | Alexander W. Marka Monika Probst Tobias Greve Nicolas Lenhart Niklas Graf Florian Probst Gustav Andreisek Thomas Frauenfelder Matthias Folwaczny Egon Burian Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes Insights into Imaging Magnetic resonance imaging Periapical osteolysis Dentistry Dental radiographs |
| title | Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes |
| title_full | Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes |
| title_fullStr | Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes |
| title_full_unstemmed | Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes |
| title_short | Periapical bone edema volume in 3D MRI is positively correlated with bone architecture changes |
| title_sort | periapical bone edema volume in 3d mri is positively correlated with bone architecture changes |
| topic | Magnetic resonance imaging Periapical osteolysis Dentistry Dental radiographs |
| url | https://doi.org/10.1186/s13244-025-01903-z |
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