32 Mandible Lesions on Computed Tomography

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig SK 32-1 Periapical cyst. (A) Axial scan and (B) reformatted image demonstrate a radiolucent lesion (arrows) surrounding the apex of a molar. A defect with dental filling (arrowhead) is present within the crown of the tooth.50

• Fig SK 32-2 Follicular cyst. Coronal reformatted image reveals a cystic lesion with an unerupted tooth in the right molar region (arrow). The crown of the tooth is contained within the lesion. Note the presence of bone remodeling rather than expansion.50

• Fig SK 32-3 Odontogenic keratocyst. In this patient with the basal cell nevus syndrome, there are multiple cysts (arrows) in the mandible. Cystic lesions (arrowheads) are also identified within the maxilla.50

• Fig SK 32-4 Solitary bone cyst. Coronal reformatted image demonstrates a cystic lesion (arrows) within the body of the mandible. The mandibular cortex is thinned. Note the normal tooth (arrowhead) within the lesion, a finding that helps distinguish the cyst from radicular or other odontogenic cysts.50

• Fig SK 32-5 Ameloblastoma. Multiloculated cystic lesion (arrow) within the left mandible. The crown of an impacted tooth (arrowhead) within the lesion is a clue to the diagnosis.50

• Fig SK 32-6 Aggressive ameloblastoma. Expansile enhancing lesion within the right mandibular body (arrows) that causes significant buccal cortical destruction. (Courtesy of Akifumi Fujita, M.D., Jichi Medical University, Shimotsuke, Japan.).50

• Fig SK 32-7 Ossifying fibroma. A circular, partially calcified lesion (arrow) within the mandible. Note the internal groundglass calcifications.50

• Fig SK 32-8 Ameloblastic carcinoma. (A) Contrast CT scan with bone windowing shows an enhancing multiloculated soft-tissue mass (arrows) with adjacent bone destruction. (B) Contrast T1-weighted MR image demonstrates the enhancing soft-tissue mass.50

• Fig SK 32-9 Osteosarcoma. Osteoblastic changes (arrows) are seen with the right mandibular body. Note the abnormal soft-tissue ossification (arrowhead).50

• Fig SK 32-10 Metastasis. Expansile, osteolytic mass (arrows) within the right mandibular body, which represents a metastasis from hepatocellular carcinoma.50

• Fig SK 32-11 Apical peridontitis. Rim-enhancing fluid collection (arrows) within the perimandibular soft tissues.50

Fig SK 32-12 Chronic osteomyelitis. Osteolytic lesion (arrow), containing a bony sequestrum (arrowhead) within the left mandibular body.50

• Fig SK 32-13 Sclerosing osteomyelitis. Diffuse sclerotic changes with expansion of the left mandibular body (arrows). Note the diffuse soft-tissue swelling (arrowheads).50

• Fig SK 32-14 Central giant cell granuloma. Cystic lesion (arrows) within the mandible with erosion of the mandibular cortex.50

• Fig SK 32-15 Arteriovenous malformation. (A) Contrast CT scan reveals multiple dilated and tortuous vessels (arrow) within the right masseter muscle. Note the abnormal enhancement (arrowhead) within the marrow of the mandible. (B) T1-weighted MR image demonstrates a slightly expansile lesion (arrow) within the right mandibular angle and body. Multiple flow voids are present within the right masseter muscle. Note the loss of normal fatty marrow (arrowhead) within the mandible.50

• Fig SK 32-16 Renal osteodystrophy. Diffuse sclerotic changes (arrows) throughout the entire mandible.50

Fig SK 32-17 Torus mandibularis. Bilateral exostoses (arrows) in the lingual aspects of the mandible.50

• Fig SK 32-18 Fibrous dysplasia. Expansile lesion containing numerous unorganized bone trabeculae (arrow) within the left mandibular body.50