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The magnetic resonance imaging characteristics of radicular cysts and granulomas

Natnicha Wamasing1, Supasith Yomtako1,2, Hiroshi Watanabe1

  • 1Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan.

Dento Maxillo Facial Radiology
|January 23, 2023
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) can differentiate radicular cysts and granulomas using specific features. Maximum diameter and lesion characteristics on MRI are key for distinguishing these two pathologies.

Area of Science:

  • Radiology
  • Medical Imaging
  • Oral and Maxillofacial Surgery

Background:

  • Radicular cysts and granulomas are common periapical inflammatory jaw lesions.
  • Distinguishing between radicular cysts and granulomas can be challenging with conventional imaging techniques.

Purpose of the Study:

  • To investigate and differentiate the MRI characteristics of radicular cysts and granulomas.
  • To identify specific MRI features that aid in distinguishing between these two lesions.

Main Methods:

  • Histopathologically confirmed cases of 27 radicular cysts and 9 granulomas were analyzed.
  • MRI sequences included fat-saturated T2-weighted, T1-weighted, and contrast-enhanced fat-saturated T1-weighted images.
  • Quantitative analysis involved lesion diameter and apparent diffusion coefficient (ADC) values, with statistical comparisons and decision tree creation.

Main Results:

  • Significant differences were observed in lesion center signal intensity (T2-weighted images), signal intensity, texture, and contrast enhancement (contrast-enhanced T1-weighted images), and maximum diameter.
  • A maximum diameter cutoff of 15.9 mm was identified for radicular cysts.
  • High diagnostic performance was achieved with an area under the ROC curve of 0.971, sensitivity of 85.2%, and specificity of 100%.

Conclusions:

  • Maximum lesion diameter, contrast enhancement, and signal intensity on specific MRI sequences are crucial for differentiating radicular cysts and granulomas.
  • A decision tree incorporating these MRI features can effectively discriminate between the two pathologies.
Keywords:
decision treesgranulomahistologymagnetic resonance imagingradicular cyst

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