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European Journal of Oral and Maxillofacial Surgery 2020 August;4(2):45-8

DOI: 10.23736/S2532-3466.20.00204-0


language: English

Analysis of computed tomography Hounsfield units of benign lesions in the maxillofacial region: is there a correlation?

Allen F. CHAMPION , Thomas M. CURIEL, Robert J. DIECIDUE

Department of Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, PA, USA

BACKGROUND: Radiolucent lesions of the maxilla and mandible are common radiographic features of several benign pathologic entities affecting the maxillofacial skeleton. Such common lesions include inflammatory cysts, dentigerous cysts, keratocystic odontogenic tumors, ameloblastomas, nasopalatine duct cysts, and giant cell lesions, amongst others. Many authors have attempted to characterize ways to predict the tissue diagnosis of a lesion based upon the radiographic presentation, taking into account the demographic data that is known for each particular lesion. However, biopsy continues to be the gold standard for pathologic diagnosis. Unfortunately, intrabony biopsies are invasive, and often times are performed prior to definitive surgical intervention. Computed tomography (CT) evaluation of Hounsfield units (HU) has shown promise in many areas of medicine, including quantifying bone density in osteoporosis, distinguishing between adrenal adenomas, and characterizing thrombi, amongst other indications. This study compared six different benign radiolucent lesions of the maxillofacial region using Hounsfield units in an attempt to find a correlation with the histopathologic diagnosis.
METHODS: Two hundred and ten benign lesions were reviewed spanning a 25-year period. Using the axial view of a CT scan, the lesion was evaluated in its largest diameter using HU. The mean and standard deviation of each group was calculated for an analysis of variance test to analyze the differences among group means for statistical significance.
RESULTS: Average HU were calculated amongst six groups of lesions examined during this study: inflammatory cysts (38.23 HU), dentigerous cysts (25.45 HU), keratocystic odontogenic tumor (22.58 HU), ameloblastoma (39.34 HU), nasopalatine duct cyst (38.03 HU), and central giant cell lesion (60.98 HU). An analysis of variances revealed a P value of 0.837, indicating no statistical significance between groups.
CONCLUSIONS: The results support the null hypothesis that although HU have been found to be a reliable indicator of hard tissues such as bone, it plays no role in the diagnosis of benign radiolucent lesions of the maxillofacial region.

KEY WORDS: Maxilla; Mandible; X-ray computed tomography; Maxillofacial abnormalities

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