Osteolysen der Kalotte

Eosinophiles

Granulom der Schädelkalotte. Oben konventionelles Röntgen, MRT sagittal T1 und T2; unten Sonografie MRT koronar T1 und sagittal FLAIR.

Osteoma •

Mastoid osteoma - Ganzer Fall bei Radiopaedia

Imaging of

skull vault tumors in adults. Hemangiopericytoma. CT (a), T2WI (b), and post-contrast T1WI (c). Dural-based “mushroom-like” mass (arrows) with brain edema (dashed-arrows), intense homogeneous enhancement, and foci of bone lysis (arrowhead)

Imaging of

skull vault tumors in adults. Bone hemangiomas. Case 1 (a–c): CT (a), T1WI (b), and T2WI (c) show well-defined lytic lesion, with thickened cortical and medullar trabecular spaces (arrows in a), and internal T1 and T2 hyperintense signal corresponding to fat and vascular tissue (arrows in b and c). Case 2 (d, e): CT (d) and T1WI (e) show marked bone expansion, fat content (dashed arrows), and strikingly enlarged trabecula producing a “spoke-wheel” appearance. Case 3 (f): CT depicts interruption of outer cortical table with overcoming enlarged spiculated trabecula simulating aggressive periosteal reaction (arrowhead)

Imaging of

skull vault tumors in adults. Eosinophilic granuloma. NECT depicts inner and outer table endosteal scalloping and erosions (arrows in a) and bone sequestra (arrowhead in b). On T2WI (c), the lesion is hyperintense and bone sequestra could also be suspected (arrowhead). T1WI post-contrast (d) demonstrates intense enhancement and cranio-caudal orientation (dashed arrow)

Imaging of

skull vault tumors in adults. Epidermoid cysts (a–c and d–f) and dermoid cyst (g–i). Case 1 (a–c): Extracranial soft-tissue mass (arrows) remodeling the outer table on NECT (a), with fluid T2-signal (b), and markedly restricted diffusion (b = 1000) (c). Case 2 (d–f): Transdiploic mass (arrowheads), predominantly intracranial, T1WI (d) and T2WI (e) heterogenous and intense diffusion restriction (f). Case 3 (g–i). Frontal skull lesion (dashed arrows) disrupting the inner table on CT (g, h); content is CT-hypodense and T1-hyperintense, corresponding to fat (i)

Imaging of

skull vault tumors in adults. Fibrous dysplasia. T2WI (a), post-contrast T1WI (b), and NECT (c). Expansile lesion with distinct lytic-cystic component (arrows) and “ground-glass” fibrous tissue (arrowheads) clearly depicted on NECT, deeply T2-hypointense, which enhances heterogeneously

Imaging of

skull vault tumors in adults. Calvarial pseudolesions. NECT (a, c–f), T2WI (b), MR venography (g, h). Parasagittal occipital arachnoid granulation (a). Occipital encephalocele (b). Dilated vascular canals and lacunae (c). Hyperostosis frontalis interna (d). Bilateral thinning of the parietal bones (e). Enlarged parietal foramina (f). Congenital sinus pericranii (g). Iatrogenic acquired sinus pericranii from a prior ventricular drainage (h)

Imaging of

skull vault tumors in adults. Osteosarcoma. Secondary, “pagetic.” T1WI post-contrast (a and b). Aggressive, destructive, giant, and transdiploic lesion with extensive intra- and extracranial soft-tissue component containing iso to hypointense areas of probable necrosis (arrows in a and b) and deeply hypointense foci of suspected bone matrix (dashed arrows in b). Note the underlying abnormal calvarial bone with diffuse expansion, cortical thickening and heterogeneous multifocal variable signal intensity, and enhancement (arrowheads) consistent with Paget disease

Imaging of

skull vault tumors in adults. Myeloma and plasmacytoma. Upper row. Myeloma. X-ray (a) NECT (b, c) and T1WI (d). Multiple “punched-out” lytic lesions with variable soft tissue components (a–c). Mandibular lesion suggesting myeloma instead of metastases (arrow in d). Note also the clival lesion (dashed arrow in d). Lower row. Plasmacytoma. NECT (e), T1WI post-contrast (f), and DSC-PWI (g). Single purely lytic transdiploic lesion with narrow zone of transition (arrows in e), hyperdense, hyperenhancing, and hypervascular (arrowheads respectively in e–g)

Intradiploic

epidermoid cyst with osteolytic lesions of the skull.. Axial post gadolinium T1-weighted MR images show minimal and peripheral contrast enhancement (arrows).

Intradiploic

epidermoid cyst with osteolytic lesions of the skull.. The ADC maps reveal restricted diffusion (arrows).

Multisystemic

Langerhans cell hystiocitosis - Head and neck involvement. Well-defined lytic lesion with a double contour (hole within a hole = button sequestrum) and geographic margins, associated to a growing soft-tissue mass (yellow arrows). Prat-Matifoll J.A, Radiology Department, Vall Hebron Hospital

Intradiploic

epidermoid cyst with osteolytic lesions of the skull.. Axial FLAIR images demonstrate an inhomogeneous hyperintense lesion in the right occipital intradiploic space (arrows).

Intradiploic

epidermoid cyst with osteolytic lesions of the skull.. Axial T2-weighted images demonstrate an inhomogeneous hyperintense lesion in the right occipital intradiploic space (arrows).

Intradiploic

epidermoid cyst with osteolytic lesions of the skull.. Computed tomography scan with bone density window reveal an occipital osteolytic lesion (arrows).

Imaging of

skull vault tumors in adults. Osteomas. Multiple in Gardner syndrome. NECT show mass-like proliferation of normal appearing cortical bone in the frontal (arrow) and cortical and medullary bones in the parieto-occipital (dashed arrow) lesions

Langerhans

cell histiocytosis (skeletal manifestations) • Langerhans cell histiocytosis - Ganzer Fall bei Radiopaedia

Imaging of

skull vault tumors in adults. Aneurysmal bone cyst (ABC). Case 1 (a–c): Primary ABC: NECT (a), T2WI (b), and post-contrast T1WI (c) show an extremely expansile, lytic, multiloculated, septated lesion, with severe cortical thinning (arrowhead in a), fluid-fluid levels (dashed arrow in b), and lineal enhancement (arrows in c). Case 2 (d–f): Fibrous dysplasia with secondary ABC: NECT demonstrates an expansile, lytic lesion with severe cortical thinning (arrowhead in d), a characteristic fluid-fluid level (arrow in f), and associated areas of “ground-glass” matrix (dashed arrows in e)

Lytic skull

lesion • Multiple myeloma - Ganzer Fall bei Radiopaedia

Imaging of

skull vault tumors in adults. Giant cell tumor of the bone. Axial NECT (a), T2WI (b), and T1WI post-contrast (c). Purely lytic lesion with severe expansion and cortical thinning (arrowhead in a), markedly T2 hypointense tissue content (arrow in b), and avid contrast-enhancement (dashed arrow in c)

Osteoma •

Calvarial osteoma - Ganzer Fall bei Radiopaedia

Lytic skull

lesion • Luckenschadel skull - Ganzer Fall bei Radiopaedia

Lytic skull

lesion • Intradiploic epidermoid cyst - Ganzer Fall bei Radiopaedia

Lytic skull

lesion • Langerhans cell histiocytosis - Ganzer Fall bei Radiopaedia

Mammakarzinom

mit osteolytischen Metastasen: Computertomographie des Schädels axial Knochenfenster. Zu sehen ist eine größere Osteolyse frontal und mehrere kleinere.

Imaging of

skull vault tumors in adults. Metastases. Lytic metastases (a–f). CT of three patients (a–c) shows: a Solitary with narrow zone of transition (arrows), b multiple with slight soft-tissue components, and (c) solitary, giant, with mixed necrotic (arrowhead) and hypervascular (dashed arrows) soft tissue. Another case (d–f) with T2WI, T1WI post-contrast, and DSC-PWI shows solitary, giant, solid-enhancing, and hypervascular soft-tissue component (arrowheads). g–i Three cases of blastic metastases. Multiple (g). Aggressive periosteal reaction (arrows in h–i)

Osteoma •

Giant skull vault osteoma involving orbital roof - Ganzer Fall bei Radiopaedia

Osteoma •

Skull osteoma - Ganzer Fall bei Radiopaedia

Imaging of

skull vault tumors in adults. Meningioma. Great polymorphism. Case 1 (a, b): Post-contrast T1WI (a) and CT (b): dural-based with dural tails (arrows) and bone lysis (dashed arrows). Case 2 (c–e): Post-contrast T1WI (c), CT (d), and DSC-PWI (e): dural-based hypervascular (arrowhead) with transdiploic growing (arrows), bone sclerosis-permeation, and aggressive-like periosteal reaction (dashed arrows). Case 3 (f, g): Post-contrast T1WI (f) and CT (g): diploic-centered plaque-like with intra- and extracranial laminar soft-tissue (arrowheads) and bone lysis-permeation (arrows). Case 4 (h): CT shows diploic-centered lesion with great spiculated hyperostosis (arrows). Case 5 (i, j) Post-contrast T1WI (i) and MR venography (j): diploic-centered with great homogeneous smooth hyperostosis (arrowhead) and intracranial soft-tissues characteristically invading the superior longitudinal venous sinus (arrows)

Osteoma •

Skull osteoma - Ganzer Fall bei Radiopaedia

Osteoma •

Skull osteoma - Ganzer Fall bei Radiopaedia

Radiological

review of skull lesions. Osseous venous vascular malformation. Sagittal T1-weighted imaging (a), axial T2-weighted imaging (b) and sagittal contrast-enhanced venogram (c) show a hypointense T1, hyperintense T2 and enhancing lesion in the occipital bone (arrows)

Radiological

review of skull lesions. Langerhans cell histiocytosis. Sagittal skull radiograph (a) shows two lytic lesions (arrowheads) in the parietal skull, the largest one with an associated soft tissue component (thin arrow). Axial head CT images (b, c) in the bone and soft tissue windows in the same patient demonstrate an osseous destructive lesion in the left frontal calvarium with bevelled edges (dashed arrows) and a soft tissue component (thick arrows); pathology proven eosinophilic granuloma in a 4-year-old boy

Lytic skull

lesion • Eosinophilic granuloma - Ganzer Fall bei Radiopaedia

Imaging of

skull vault tumors in adults. Lymphoma. Case 1 (a–d): NECT (a, b), post-contrast T1WI (c), and ADC map (d). Transdiploic mass with bone subtle sclerosis (arrows) and disproportionate soft-tissue components dense on CT, homogenously enhancing, and diffusion-restricting (arrowheads). Case 2 (e–g): Similar findings with bone lytic-permeation (arrows) instead

Imaging of

skull vault tumors in adults. Miscellany. Paget disease (a, b) CT (a) and X-ray (b): Characteristic mixed bone lysis and sclerosis, cortical bone thickening, and expansion. Osteoporosis circumscripta cranii CT (c, d): large geographic radiolucent areas involving medullar and cortical bone in frontal and occipital regions (arrows). Amyloidoma (e, f) CT (e) and T2WI (f): Giant heterogeneous mass with marked T2 hypointensity and calcifications. Renal osteodystrophy CT (g): shows characteristic “salt-and-pepper pattern.” Brown tumor (h, i): unspecific well-defined, cystic appearance (arrows). Thalassemia CT (j): Diffuse diploic widening and “hair-on-end” appearance (arrow) with characteristic occipital bone preservation (arrowhead). Bone sarcoidosis (k, l) CT (k) and T2WI (l): Mixed predominantly lytic multiple lesions with lace-like internal pattern of calcification and T2 hypointensity (dashed arrows). Osteitis CT (m, n): Bone focal lysis and erosions of osteitis (arrows) contiguous to a frontal sinusitis complicated with intracranial laminar abscess (dashed arrow)