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AJNR - American Journal of Neuroradiology

Published ahead of print on August 21, 2008
doi: 10.3174/ajnr.A1266

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Diffusion-Weighted MR Imaging of Ameloblastomas and Keratocystic Odontogenic Tumors: Differentiation by Apparent Diffusion Coefficients of Cystic Lesions

M. Sumi^a, Y. Ichikawa^a, I. Katayama^a, S. Tashiro^a and T. Nakamura^a

^a From the Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan

View larger version (96K): [in this window] [in a new window]   Fig 1. A 47-year-old man with ameloblastoma at the mandible. A, Axial T1-weighted image (TR, 500 ms; TE, 15 ms) shows the tumor (arrowhead) with low to intermediate signal intensity. B, Axial fat-suppressed (SPIR) T2-weighted image (TR, 3741 ms; TE, 80 ms) shows large, multiloculated cystic lesion with high signal intensity (arrowhead) indicative of cystic cavity. C, Axial color ADC map shows cystic tumor (arrowhead) with high ADC (2.50 x 10–3 mm2/s). Broken line indicates an irregular region of interest placed in the nonenhancing lesion. D, Photomicrograph shows solid tumor lesion associated with multiple small cysts, exhibiting a follicular pattern of tumor cell proliferation with peripheral palisading. Original magnification x10.

View larger version (101K): [in this window] [in a new window]   Fig 2. A 23-year-old man with ameloblastoma at the right mandible. A, Axial fat-suppressed (SPIR) T2-weighted image (TR, 3000 ms; TE, 90 ms) obtained by a 4.7-cm microscopy coil shows the tumor (arrowheads) with high signal intensity in the mandibular ramus. A solid lesion (arrow) is also observed. B, Axial contrast-enhanced T1-weighted image (TR, 550 ms; TE, 10 ms) shows the tumor (arrowheads) with clear definition between solid (arrow) and nonenhancing lesions. C, Axial color ADC map shows the tumor (arrowheads) consisted of nonenhancing lesion with high ADC (2.67 x 10–3 mm2/s) and a solid lesion (arrow) with intermediate ADC (1.50 x 10–3 mm2/s). Two broken lines indicate irregular regions of interest placed in solid (small) and nonenhancing (large) lesions. D, Photomicrograph shows large nonenhancing lesion (*) associated with solid lesion containing follicular pattern of tumor cell proliferation with varying degrees of cystic degeneration in tumor islands. Original magnification x1.

View larger version (86K): [in this window] [in a new window]   Fig 3. A 33-year-old man with a keratocystic odontogenic tumor at the right mandible. A, Axial T1-weighted image (TR, 500 ms; TE, 15 ms) shows a multilobulated cystic lesion with intermediate signal intensity (arrowhead). B, Axial fat-suppressed (SPAIR) T2-weighted image (TR, 5118 ms; TE, 80 ms) shows tumor (arrowhead) composed mainly of nonenhancing lesion with intermediate signal intensity. C, Axial color ADC map shows nonenhancing lesion (arrowhead) with low ADC (0.67 x 10–3 mm2/s). Broken line indicates an irregular region of interest placed in nonenhancing lesion. D, Photomicrograph shows cyst wall consisting of parakeratinized stratified squamous epithelium. Original magnification x10.

View larger version (19K): [in this window] [in a new window]   Fig 4. Scatterplot shows ADCs of nonenhancing and solid lesions of ameloblastomas and keratocystic odontogenic tumors. Horizontal lines indicate means of respective groups. P, Mann-Whitney U test.