脈りゅう性骨嚢胞に対するＲＩ‐ａｎｇｉｏｇｒａｐｈｙの有用性

Abstract

This paper described an usefullness of RI-angiography in diagnosis of aneurysmal bone cyst, an extremely rare nonodontgenic disease occurring in the jaws. A 14-year-old boy visited our clinic, complaing of swelling of the left side of mandible. Intraoral examination revealed buccal and lingual bone expansion of the lower left molar region. Radiographs revealed a multilocular radiolucent area on the mandible left side. A clinical diagnosis of ameloblastoma was suspected under these findings. We experienced pulsatory bleeding from the lesion during biopsy.We suspected an angiomatous lesion and performed ultrasonic examination, CT scaning and angiography. The results revealed that there was little possibility of angiomatous lesion, so that we again tried a biopsy and the specimen indicated a diagnosis of cavernous hemangioma. Furthermore we performed RI-angiography to asses the vascularity of the lesion, but the pattern of cavernous hemangioma was not demonstrated. Aneurysmal bone cyst was strongly suspected by RI-angiographic in addition to clinical, roentographic and angiographic findings. Under general anesthesia, all cystic tissue was removed from the cavity by careful curettage intraorally. Histopathologically, the lesion consisted of a fibrous connective tissue stroma containing numerous capillaries. In some region, osteoid formations were seen and a few giant cells were present.The lesion was finally diagnosed as aneurysmal bone cyst. The agreement with the RIangiography finding and the histopathological diagnosis suggested that RI-angiography examination was effective for diagnosis of aneurysmal bone cyst.