Table 2.
Computed tomography and magnetic resonance imaging appearance of bone tumors of the maxillofacial region
| Incidence | Computed tomography | Magnetic resonance imaging | |
| Osteoma | 5th-6th decade | Compact: dense sclerotic | Compact: signal void |
| Cancellous: mixed densities | Cancellous: low to absent signal | ||
| Sharp, well defined lesion attached by a broad base or pedicle to the bone | |||
| Osteoid osteoma | 2nd-3rd decade | Radio lucent nidus (< 1.5 cm) surrounded by dense sclerosis | Non specific signal intensity with patchy enhancement |
| Osteoblastoma | 2nd decade | Expansile lesion with cortical shell | Non specific signal intensity |
| May mixed or sclerotic lesion | |||
| Chondroblastoma | More than 30 yr | Lytic lesion with central calcifications and peripheral thin cortical shell | Signal void regions of calcification |
| Chondromyxoid fibroma | 2nd-3rd decade | Well-demarcated expansile lesion with multiple foci of calcification | Signal void regions of calcification |
| Chondroma | Less than 50 yr | Small polypoid mass with few discrete areas of calcifications | Non specific appearance |
| Osteochondroma | 2nd-4th decade | Mushroom shaped bony outgrowth with calcified cartilagenous cap | Hypointense bony outgrowth with hyperintense cartilaginous cap |
| Fibrous dysplasia | 1st-2nd decade | Ground glass appearance (56%), sclerotic (23%) | Variable signal intensity depends upon amount of fibrous and sclerotic regions |
| Lytic with sclerotic margins (21%) | |||
| Giant cell tumor | 3rd-4th decade | Expansile mass that tends to destroy and remodel the adjacent bone | Low signal on all sequences |
| Aneurysmal bone cyst | 2nd decade | Lytic expansile lesion with multi-locular "soap bubble" (honey comb) and may fluid–fluid levels | Fluid fluid level with septal enhancement |
| Hemangioma | 2nd decade | Sunburst or spoke wheel pattern of radiating trabeculae | Stippled appearance with intense enhancement |
| Meningioma | 4th decade | Osteoblastic or mixed sclerotic lesion | Low signal on all sequences with intense enhancement |
| Osteosarcoma | 3rd decade | Commonly sclerotic lesion with calcified matrix and sunburst periosteal reaction or it may be mixed or lytic lesion | Signal void of calcification and new bone formation with heterogeneous contrast enhancement |
| Chondrosarcoma | 4th-5th decade | Bony destructive lesion with multiple punctate and stippled calcifications | T2WI: hyperintense areas (chondroid) and hypointense areas (calcified). Curvilinear enhancement |
| Ewing sarcoma | 1st-2nd decade | Destructive aggressive mass with mottled lucent areas and sclerosis and onion peal periosteal reaction | Non specific signal intensity with inhomogeneous enhancement |
| Fibrosarcoma | 3rd-6th decade | Destructive bony lesion, frequently associated with extra osseous soft tissue mass | Low to intermediate signal intensity with inhomogeneous enhancement |
| Hemangio-endothelioma | 2nd decade | Multifocal lytic lesion or dense sclerotic lesion | Tubular signal void structures with intense enhancement |
| Chordoma | 4th decade | Hypodense mass with irregular intratumoral calcifications (30%-50%) with bone destruction | Mixed signal intensity with inhomogeneous enhancement |
| Lymphoma | 4th-7th decade | Lytic, sclerotic or mixed lesions that may be associated with soft tissue mass | Non specific magnetic resonance imaging appearance |
| Plasmacytoma | 4th-7th decade | Well defined bony expansile lesion with intense enhancement | Low SI on T1-weighted images, high on T2-weighted images with intense enhancement |
| Metastasis | All ages | Radiolucent lesion with cortical destruction. May sclerotic or mixed lytic and sclerotic | Non specific magnetic resonance imaging appearance |
SI: Signal intensity