Calvarial lesions: A radiological approach to diagnosis

Abstract

Calvarial lesions are frequently identified in radiological studies. A wide variety of neoplasms and non-neoplastic lesions can involve the calvarium, and their imaging appearances vary according to their pathologic features. These lesions are usually asymptomatic but may manifest as a lump with or without associated pain. Clinical information, including the age of patient, is an important factor in the diagnostic process. In this paper, we illustrate the value of cross-sectional imaging techniques by computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating these lesions. We also review the literature and discuss the specific imaging characteristics of the most common calvarial lesions in order to provide information that can guide radiological diagnosis or limit differential diagnosis.

Cross Sectional Imaging of Solitary Lesions of the Neurocranium

“…On CT, epidermoid cysts are visualized as hypodense, lobulated, osteolytic masses in a typical location and usually have a smooth border with thinning and more rarely rupture of the internal and external table [1] (▶ Fig. 5A).…”

“…On T2w images, lesions can appear very hypointense or also extremely hyperintense depending on the relationship between fibrous tissue and bony matrix [27]. After contrast administration, enhancement with low signal intensity tends to be characteristic for these lesions but intense enhancement is also possible [1] (▶ Fig. 7B, C).…”

“…0.8 % of all bone tumors [1], while secondary manifestations of a primary disease (e. g. metastases) or infiltrative processes from an adjacent region (e. g. meningiomas) are more common.…”

Radiological Approach to Osteolytic Benign Calvarial Lesions

“…It is observed hypointense in T1 weighted sequences, hyperintense in T2 sequences and isointense with the muscular tissue. It has prominent contrast enhancement in MRI 11,21,22 . If the patient has no complaint, follow-up without treatment is suggested.…”

Ekstraaksiyel Beyin Tumorleri

“…Kalvaryumun primer neoplazmları tüm kemik tümörlerinin %0,8'ini oluşturur. Benign neoplazmlar malign olanlara göre daha sıktır [161,162]. BT görüntüler kemik destrüksiyonunu, internal ve eksternal tabulaların ve diploenin tutulumunu, tümör matriksini değerlendirmek için önemlidir.…”