Magnetic resonance imaging of normal and osteomyelitis in the mandible: assessment of short inversion time inversion recovery sequence.

Abstract

We sought to determine the suitable magnetic resonance imaging conditions for the short inversion time inversion recovery (STIR) sequence through the use of phantoms; to describe the signal characteristics of normal structures in the mandible; and to evaluate the usefulness of STIR images in enabling the identification of mandibular osteomyelitis on conventional T1- and T2-weighted spin-echo images. Suitable mandibular STIR imaging conditions were determined by varying inversion time and repetition time in each sequence. STIR magnetic resonance images of 162 healthy subjects and STIR and T1- and T2-weighted spin-echo images of 21 subjects with mandibular osteomyelitis were evaluated. In STIR imaging, the signal of oil was suppressed at an inversion time equaling 100 milliseconds and a repetition time equaling 1500 to 3000 milliseconds. In healthy subjects, the mandibular marrow was revealed to have high signal intensities (100%) and cortical bone had no signal intensities (100%) on STIR images. In surrounding soft tissue in these healthy subjects, the submandibular glands were shown to have high signal intensities (100%); the parotid glands had intermediate to high signal intensities (100%); the sublingual glands had high (88.9%) and intermediate to high (11.1%) signal intensities; lymph nodes had high signal intensities (100%); and the masseter muscles had intermediate signal intensities (100%) on STIR images. The lesions in bone marrow had low (75%) and low to intermediate (25%) signal intensities on T1-weighted images and high (54%), intermediate to high (29%), and intermediate (17%) signal intensities on T2-weighted images. On STIR images, the signal intensities resulted in high (75%), intermediate to high (21%), and intermediate (4%) signal intensities. STIR imaging is highly effective for the evaluation of bone marrow and surrounding soft tissue in terms of the detection of osteomyelitis in the mandible and the identification of inflammation spreading to soft tissue.