MALIGNANT GRANULOMAS OF THE CENTER OF THE FACE - VALUE OF CT/MR IMAGING

CT and MR imaging are now an integral part of the work-up of every ulcerative lesion of the mid-face. The CT scan enables an exhaustive evaluation of the bone and cartilage necrosis by using bone densitometry settings. The mass lesions, the inflammatory areas and the thickened mucosa are best demonstrated using the tissue densitometry settings. Injection of iodinated contrast material makes clearer delineations of the abnormalities, but doesn't differentiate well between muco-purulent fluid retentions (in the sinuses for example) and solid neoplastic masses. MRI is the technic of choice for this goal; it also gives helpful images in the sagittal and frontal planes. CT and MR imagings are best combined to guide the surgical biopsies and the radiation therapy when managing the difficult problem of mid-face ulcerative lesions.