Pshenichnikova E.S., Babkova A.A., Serova N.S., Pankratov A.S., Shamanaeva L.S.

Purpose. To show the possibilities of methods of radiation diagnostics (multispiral computed

tomography (MSCT)) and cone-beam computed tomography (CBCT)) in detecting actinomycosis of the mandible in a patient with radionecrosis after repeated surgical treatment for squamous cell carcinoma of the lateral surface of the tongue.

Material and methods. A clinical observation of a patient R., 64 years old, with complaints of amandibular defect, difficulty eating and violation of articulation is presented. To identify pathological changes, the patient was sent to the radiology department to perform cone-beam computed tomography (CBCT) of the facial skeleton bones.

Results. The possibilities of CBCT in actinomycosis of the mandible on the background of radionecrosis in a patient after surgical treatment and courses of radiation therapy for squamous cell carcinoma of the lateral surface of the tongue are described. The diagnosis was verified by histological examination of surgical material.

Discussion. Actinomycosis, as a rule, develops in patients with immunodeficiency, also on the background of radionecrosis after courses of radiation therapy. The "gold standard" of diagnostics is the detection of actinomycotic druses in histological and cytological preparations. However, modern highly informative methods of radiology, such as MSCT and CBCT, allow to identify radiological signs characteristic of this pathology.

Conclusion. CBCT, as well as MSCT, in the study of the maxillofacial region in patients with actinomycosis, allows to obtain full diagnostic information about the localization and prevalence of the lesion, which determines the further tactics of the patient's management, taking into account his challenging history.

Discussion. The pathogenesis of сhronic cerebrovascular accident with the development of endothelial dysfunction and, as a consequence, capillary stasis explains the changes in cerebral blood flow detected by the arterial spin labeling method. Regular cognitive-behavioral training causes a steady local increase in blood flow, thereby indicating the effectiveness of the therapy, which is objectively confirmed not only by the cognitive status of the patient, but also with the help of arterial spin labeling.

Conclusion. Arterial spin labeling is indicated in the primary diagnosis of Chronic cerebrovascular accident, to assess the degree of damage to the microcirculatory bed, as well as in dynamics to determine the effectiveness of therapy.

I.M. Sechenov First Moscow State Medical University of the Ministry (Sechenov University). Moscow, Russia.


Keywords: actinomycosis, mandible, MSCT, CBCT, radionecrosis, cancer, radiation therapy.


Corresponding author: Pshenichnikova E.S., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript .


For citation: Pshenichnikova E.S., Babkova A.A., Serova N.S., Pankratov A.S., Shamanaeva L.S. Radiology of actinomycosis in a patient with radionecrosis of the mandible (long-term follow-up). REJR 2021; 11(4):7-19. DOI: 10.21569/2222-7415-2021-11-4-7-19.

Received:        31.08.21                 Accepted:       23.09.21