CT and MRI features of scalp lesions

Scalp lesions can be classified as congenital, traumatic, inflammatory, or neoplastic in origin. Although patients presenting with scalp masses are frequently seen in daily practice, differentiation of scalp lesions is often challenging for radiologists who are not familiar with the imaging of cutaneous lesions. The majority of scalp lesions are fortunately benign, with cystic lesions accounting for over 50% of all benign scalp lesions. Such lesions include trichilemmal cysts (pilar cysts), sebaceoma, epidermoid cysts, dermoid cysts, and teratoid cysts. Radiologists may also occasionally encounter benign neoplasms of the scalp, including melanocytic nevi, keratoacanthoma, pilomatricoma, neurofibroma, and lipoma. Malignant scalp tumors are uncommon; however, they carry a potential risk of delayed detection, resulting in poorer outcomes. Most scalp lesions show nonspecific imaging findings, although some possess characteristic features on CT and MRI. Radiologists must be familiar with the appearances of common scalp lesions to reach an accurate diagnosis. Hence, the aim of this article is to describe the clinical and imaging features of scalp lesions.