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They demonstrate an intermediate signal on T1-weighted images and hyperintensity on T2-weighted images, with enhancement after contrast-medium injection. They can be heterogeneous in the case of cystic or hemorrhagic transformations and may undergo malignant transformation, which is suggested by pain and rapid growth. Their spread follows the course of the nerves with smooth enlargement of their foramina. Neurofibromas are more complex lesions that involve the nerve fibers. It can exhibit a target-like pattern of increased peripheral signal intensity and decreased central signal intensity on T2-weighted images because of its fibrous central core. Vascular lesions Vascular lesions include tumors and vascular abnormalities Figure 5Figure 6Figure 7.
These lesions are usually hyperintense on T2-weighted images and tend to involve more than one deep facial space.
Hemangiomas and vascular malformations of the head and neck: Capillary hemangiomas arise in early infancy, and involution occurs by adolescence. Hemolymphangioma is a pediatric condition that tends to recur and, thus, has a less-than-favorable outcome. Imaging shows multicystic lesions with septa, and some of these loculi are hyperattenuating on CT as a consequence of hemorrhage. Figure 5 Figure 5. Angioma involving the subcutaneous tissues is seen on axial MRI T1-weighted AT2- and fat-saturation-weighted Band T1-weighted after injection and fat saturation C images as a serpiginous lesion in the right masticator space, with hyperintense signals on T2 and enhancement after gadolinium contrast administration.
MR angiography reveals the vascular origin of this lesion D.
Figure 6 Figure 6. Vascular malformation on axial CT shows A a tubular lesion of the left masticator space lying datign the masticatory boundaires but without their involvement, and B strong enhancement after contrast injection. The lesion was hyperintense on T2-weighted images C. Malformation vasculaire. Biopsies of all primary tumors for histologic diagnosis were performed for all patients before treatment. The MRI was performed on spiral echo SE sequence, with scanning directions of cross section, sagittal plane, and coronal plane. The following MRI sequences were applied: Two radiologists specialized in head and neck cancers independently evaluated all scans.
For the subsequent rebound, an unreasonable cervical field was remorseful. Patients without MSI were cast as grade 0.
Any disagreements were resolved by consensus. As described above, the masticator space complex includes the medial and lateral pterygoid muscles, the masseter muscle, the temporalis muscle, and any spaces between them. Patients without MSI were recorded as grade 0. Patients with medial pterygoid muscle involvement but without lateral pterygoid muscle involvement or infratemporal fossa involvement recorded as grade 1. Patient treatment All patients received radical radiotherapy. Two different techniques were applied for the patients in different TNM stages.
In this study, The patients at early stages stages I and II were treated using radiotherapy alone. The techniques of low melting-point lead block, multi-leaf collimator MLCthermoplastic mask and source axis distance SAD were applied to radiotherapy.
Cobalt Co gamma-rays or MV supervoltage X rays generated by a linear accelerator were used for external irradiation. Cobalt Co gamma-rays or supervoltage X ray added beta-rays were used to compensate the dose in consideration of skin and subcutaneous tissues in the neck. The prescribed radiation doses of 3D-CRT were defined as follows [ 17 ]: GTVnx nasopharynx gross tumor volume: The prescribed radiation dose of IMRT was defined as follows [ 1819 ]: The treatment was delivered by a dynamic, multileaf, intensitymodulating collimator called MIMiC.