Maxillofacial Imaging Anatomy CT AND MRI imaging
Maxillofacial Imaging Anatomy CT AND MRI imaging
Maxillofacial Imaging Anatomy CT AND MRI imaging
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<strong>Maxillofacial</strong> <strong>Imaging</strong> <strong>Anatomy</strong><br />
<strong>CT</strong> <strong>AND</strong> <strong>MRI</strong> <strong>imaging</strong>
detectors<br />
<strong>CT</strong> SCAN<br />
Basic Principles<br />
x-ray source<br />
Instead of film, radiation detectors measure the radiation<br />
attenuation as the beam passes through the body.<br />
The detectors are connected to a computer that uses algorithms<br />
to process the data into useful images that are then recorded<br />
on film and viewed on a computer monitor.
7G: Multislice<br />
Helical <strong>CT</strong>
79 Maxilla<br />
81 Maxillary sinus<br />
104B Nasal bone<br />
106 Nasal septum<br />
122 Perpendicular plate of<br />
ethmoid bone<br />
23 Frontal bone<br />
24 Frontal process of maxilla<br />
25 Frontal sinus<br />
38 Incisive canal<br />
42 Inferior turbinate<br />
48 Lacrimal sac fossa<br />
58 Mandible<br />
149 Vomer
10 Concha bullosa<br />
12 Crista galli<br />
15 Ethmoid sinus<br />
23 Frontal bone<br />
25 Frontal sinus<br />
34 Hard palate<br />
38 Incisive canal<br />
40 Inferior meatus<br />
42 Inferior turbinate<br />
43 Infraorbital canal<br />
49 Lamina papyracea of<br />
ethmoid<br />
60 Mandibular canal 113 Orbit<br />
62 Mandibular foramen<br />
81 Maxillary sinus<br />
99 Middle meatus<br />
100 Middle turbinate<br />
101 Middle suture of hard<br />
palate<br />
109 Nasolacrimal canal
15 Ethmoid sinus<br />
30 Greater palatine canal<br />
32 Greater wing of<br />
sphenoid bone<br />
41 Inferior orbital fissure<br />
42 Inferior turbinate<br />
49 Lamina papyracea of<br />
ethmoid<br />
60 Mandibular canal<br />
100 Middle turbinate<br />
115 Palatal recess of maxillary<br />
sinus<br />
122 Perpendicular plate of<br />
ethmoid bone<br />
144 Superior turbinate<br />
151 Zygomatic arch
21 Foramen rotundum<br />
36 Hyoid bone 133 Sphenoid<br />
sinus<br />
33 Hamulus of medial pterygoid<br />
plate<br />
51 Lateral pterygoid plate<br />
134 Sphenoid sinus septum<br />
64 Mandibular ramus<br />
96 Medial pterygoid plate<br />
60 Mandibular canal<br />
125 Pterygoid fossa<br />
133 Sphenoid sinus<br />
151 Zygomatic arch
20 Foramen ovale<br />
29 Glenoid fossa<br />
36 Hyoid bone<br />
64 Mandibular ramus<br />
61 Mandibular condyle<br />
114 Oropharynx<br />
132 Sphenoid bone<br />
133 Sphenoid sinus<br />
148 Uvula
134 Sphenoid sinus septum<br />
8 Carotid canal<br />
9 Clivus<br />
11 Coronoid process<br />
15 Ethmoid sinus<br />
23 Frontal bone<br />
24 Frontal process of maxilla<br />
41 Inferior orbital fissure<br />
47 Lacrimal bone<br />
49 Lamina papyracea of ethmoid<br />
52 Lateral recess of sphenoid sinus<br />
61 Mandibular condyle<br />
81 Maxillary sinus<br />
100 Middle turbinate<br />
105 Nasal cavity airway<br />
106 Nasal septum 132 Sphenoid<br />
bone<br />
109 Nasolacrimal canal<br />
111 Olfactory recess 133<br />
Sphenoid sinus<br />
135 Sphenozygomatic suture<br />
150 Zygoma<br />
151 Zygomatic arch
11 Coronoid process<br />
30 Greater palatine canal<br />
40 Inferior meatus<br />
42 Inferior turbinate<br />
43 Infraorbital canal<br />
51 Lateral pterygoid plate<br />
53 Lesser palatine canal<br />
63 Mandibular notch<br />
61 Mandibular condyle<br />
64 Mandibular ramus<br />
96 Medial pterygoid plate<br />
97 Medial wall of maxillary<br />
sinus<br />
109 Nasolacrimal canal<br />
110 Nasopharynx<br />
125 Pterygoid fossa<br />
128 Pterygopalatine fossa
2 -Alveolar recess of<br />
maxillary sinus<br />
4 Anterior nasal spine<br />
31 Greater palatine foramen<br />
38 Incisive cana<br />
34 Hard palate<br />
39 Incisive foramen<br />
51 Lateral pterygoid plate<br />
53 Lesser palatine canal<br />
63 Mandibular notch<br />
64 Mandibular ramus<br />
80 Maxillary alveolar bone<br />
92 Maxillary tooth root<br />
94 Maxillary tuberosity 81<br />
Maxillary sinus<br />
101 Middle suture of hard<br />
palate<br />
138 Styloid process<br />
126 Pterygoid process of<br />
sphenoid
39 Incisive foramen<br />
60 Mandibular canal 62 Mandibular foramen<br />
66 Mandibular tooth 1, central incisor<br />
67 Mandibular tooth 2, lateral incisor<br />
68 Mandibular tooth 3, canine<br />
69 Mandibular tooth 4, first premolar<br />
70 Mandibular tooth 5, second premolar<br />
71 Mandibular tooth 6, first molar<br />
72 Mandibular tooth 7, second molar<br />
73 Mandibular tooth 8, third molar<br />
74 Mandibular tooth crown pulp<br />
80 Maxillary alveolar bone<br />
83 Maxillary tooth 1, central incisor<br />
84 Maxillary tooth 2, lateral incisor<br />
85 Maxillary tooth 3, canine<br />
86 Maxillary tooth 4, first premolar<br />
87 Maxillary tooth 5, second premolar<br />
88 Maxillary tooth 6, first molar<br />
89 Maxillary tooth 7, second molar<br />
91 Maxillary tooth crown pulp<br />
93 Maxillary tooth root canal<br />
126 Pterygoid process of sphenoid<br />
130 Retromolar trigone
26 Genial process of mandible<br />
59 Mandibular alveolar bone<br />
60 Mandibular canal<br />
71 Mandibular tooth 6, first molar<br />
75 Mandibular tooth root<br />
76 Mandibular tooth root canal<br />
98 Mental foramen
37 Incisive artery canal<br />
59 Mandibular alveolar bone<br />
60 Mandibular canal<br />
80 Maxillary alveolar bone<br />
81 Maxillary sinus<br />
94 Maxillary tuberosity
60 Mandibular canal
60 Mandibular canal<br />
62 Mandibular foramen<br />
37 Incisive artery canal
3 Anterior belly of digastric<br />
muscle<br />
6 Buccal space fat<br />
7 Buccinator muscle<br />
11 Coronoid process<br />
27 Genioglossus muscle<br />
28 Geniohyoid muscle<br />
34 Hard palate<br />
42 Inferior turbinate<br />
58 Mandible<br />
77 Masseter muscle<br />
81 Maxillary sinus<br />
100 Middle turbinate<br />
103 Mylohyoid muscle<br />
123 Platysma muscle<br />
133 Sphenoid sinus<br />
145 Temporalis muscle<br />
146 Tongue, oral<br />
151 Zygomatic arch
3 Anterior belly of digastric muscle<br />
7 Buccinator muscle<br />
11 Coronoid process<br />
20 Foramen ovale<br />
27 Genioglossus muscle<br />
28 Geniohyoid muscle<br />
35 Hyoglossus muscle<br />
36 Hyoid bone<br />
50 Lateral pterygoid muscle<br />
55 Lingual septum<br />
58 Mandible<br />
61 Mandibular condyle<br />
64 Mandibular ramus<br />
77 Masseter muscle<br />
95 Medial pterygoid muscle<br />
102 Mylohyoid line (ridge)<br />
103 Mylohyoid muscle<br />
117 Parapharyngeal space<br />
118 Parotid gland<br />
123 Platysma muscle<br />
131 Soft palate<br />
132 Sphenoid bone<br />
141 Submandibular gland<br />
142 Submandibular space<br />
145 Temporalis muscle<br />
151 Zygomatic arch
4 Anterior nasal spine<br />
6 Buccal space fat<br />
11 Coronoid process<br />
16 External auditory canal<br />
22 Fossa of Rosenmüller (lateral pharyngeal<br />
fold)<br />
34 Hard palate<br />
44 Infratemporal fossa<br />
50 Lateral pterygoid muscle<br />
51 Lateral pterygoid plate<br />
60 Mandibular canal<br />
64 Mandibular ramus<br />
77 Masseter muscle<br />
78 Mastoid process<br />
81 Maxillary sinus<br />
95 Medial pterygoid muscle<br />
96 Medial pterygoid plate<br />
106 Nasal septum<br />
107 Nasal vestibule<br />
110 Nasopharynx<br />
117 Parapharyngeal space<br />
118 Parotid gland<br />
124 Posterior belly of digastric<br />
muscle<br />
138 Styloid process<br />
145 Temporalis muscle
3 Anterior belly of digastric<br />
muscle<br />
5 Base of tongue<br />
14 Epiglottis<br />
27 Genioglossus muscle<br />
28 Geniohyoid muscle<br />
35 Hyoglossus muscle<br />
36 Hyoid bone<br />
55 Lingual septum<br />
58 Mandible<br />
77 Masseter muscle<br />
103 Mylohyoid muscle<br />
123 Platysma muscle<br />
137 Sternocleidomastoid<br />
muscle<br />
138 Styloid process<br />
140 Sublingual space<br />
141 Submandibular gland<br />
142 Submandibular space
<strong>MRI</strong>
Basic Principles<br />
POLARIZATION.<br />
RESONANCE.<br />
RELAXATION
The signal density:<br />
Lesion<br />
Mucosal<br />
thickness<br />
Cyst<br />
Serum<br />
Blood<br />
T1<br />
Intermediate<br />
Low<br />
Low<br />
High<br />
T2<br />
High<br />
High<br />
High<br />
High
The signal density:<br />
Foreign body<br />
Polyp<br />
Mucocele<br />
Low<br />
Low<br />
High<br />
Low<br />
Very high<br />
High
3 Anterior belly of digastric<br />
muscle<br />
7 Buccinator muscle<br />
15 Ethmoid sinus<br />
25 Frontal sinus<br />
27 Genioglossus muscle<br />
28 Geniohyoid muscle<br />
42 Inferior turbinate<br />
60 Mandibular canal<br />
65 Mandibular tooth<br />
81 Maxillary sinus<br />
82 Maxillary tooth<br />
100 Middle turbinate<br />
103 Mylohyoid muscle<br />
106 Nasal septum<br />
113 Orbit<br />
123 Platysma muscle<br />
139 Sublingual gland<br />
140 Sublingual space<br />
146 Tongue, oral
6 Buccal space fat<br />
11 Coronoid process<br />
27 Genioglossus muscle<br />
35 Hyoglossus muscle<br />
55 Lingual septum<br />
77 Masseter muscle<br />
103 Mylohyoid muscle<br />
142 Submandibular space<br />
145 Temporalis muscle<br />
146 Tongue, oral<br />
151 Zygomatic arch
1 Adenoidal tissue<br />
(nasopharyngeal tonsil)<br />
11 Coronoid process<br />
19 Facial vein<br />
42 Inferior turbinate<br />
50 Lateral pterygoid muscle<br />
54 Levator labii superioris<br />
muscle<br />
61 Mandibular condyle<br />
77 Masseter muscle<br />
81 Maxillary sinus<br />
95 Medial pterygoid muscle<br />
104 Nasal ala<br />
106 Nasal septum<br />
145 Temporalis muscle<br />
147 Torus tubarius<br />
151 Zygomatic arch
11 Coronoid process<br />
15B Eustachian tube<br />
22 Fossa of Rosenmüller<br />
(lateral pharyngeal fold)<br />
42 Inferior turbinate<br />
44 Infratemporal fossa<br />
45 Internal carotid artery<br />
47 Lacrimal bone<br />
50 Lateral pterygoid muscle<br />
56 Longus colli muscle<br />
61 Mandibular condyle<br />
64 Mandibular ramus<br />
77 Masseter muscle<br />
78 Mastoid process<br />
81 Maxillary sinus<br />
106 Nasal septum<br />
110 Nasopharynx<br />
117 Parapharyngeal space<br />
118 Parotid gland<br />
145 Temporalis muscle
6 Buccal space fat<br />
7 Buccinator muscle<br />
13 Dens axis<br />
19 Facial vein<br />
45 Internal carotid artery<br />
46 Internal jugular vein<br />
50 Lateral pterygoid muscle<br />
56 Longus colli muscle<br />
57 Major zygomatic muscle<br />
64 Mandibular ramus<br />
77 Masseter muscle<br />
95 Medial pterygoid muscle<br />
112 Orbicularis oris muscle<br />
118 Parotid gland<br />
119 Parotid gland, accessory<br />
120 Parotid gland, deep lobe<br />
121 Parotid gland, superficial<br />
lobe<br />
136 Stensen’s duct<br />
148 Uvula
5 Base of tongue<br />
13 Dens axis<br />
28 Geniohyoid muscle<br />
45 Internal carotid artery<br />
46 Internal jugular vein<br />
77 Masseter muscle<br />
95 Medial pterygoid<br />
muscle<br />
116 Palatine tonsil<br />
118 Parotid gland<br />
124 Posterior belly of digastric<br />
muscle<br />
127 Pterygomandibular space<br />
129 Retromandibular vein<br />
130 Retromolar trigone<br />
148 Uvula
28 Geniohyoid muscle<br />
35 Hyoglossus muscle<br />
77 Masseter muscle<br />
103 Mylohyoid muscle<br />
116 Palatine tonsil<br />
118 Parotid gland<br />
139 Sublingual gland<br />
140 Sublingual space
3 Anterior belly of digastric muscle<br />
28 Geniohyoid muscle<br />
35 Hyoglossus muscle<br />
45 Internal carotid artery<br />
46 Internal jugular vein<br />
56 Longus colli muscle<br />
58 Mandible<br />
141 Submandibular gland<br />
142 Submandibular space
3 Anterior belly of digastric<br />
muscle<br />
14 Epiglottis<br />
17 External carotid artery<br />
18 External jugular vein<br />
45 Internal carotid artery<br />
46 Internal jugular vein<br />
103 Mylohyoid muscle<br />
123 Platysma muscle<br />
137 Sternocleidomastoid muscle<br />
141 Submandibular gland<br />
143 Submental space
1 Anterior band of articular disc)<br />
2 Articular disc<br />
4 Glenoid fossa<br />
5 Inferior joint space<br />
6 Intermediate (central) thin zone<br />
7 Lateral pterygoid muscle raphe<br />
8 Lower head of lateral pterygoid muscle<br />
9 Mandibular condyle (head)<br />
12 Posterior band of articular disc<br />
13 Posterior disc attachment<br />
14 Superior joint space<br />
15 Upper head of lateral pterygoid muscle
1 Anterior band of articular disc<br />
3 Articular tubercle (eminence)<br />
4 Glenoid fossa<br />
6 Intermediate (central) thin zone<br />
7 Lateral pterygoid muscle raphe<br />
8 Lower head of lateral pterygoid<br />
9 Mandibular condyle (head)<br />
12 Posterior band of articular disc<br />
13 Posterior disc attachment<br />
15 Upper head of lateral pterygoid muscle
1 Anterior band of articular disc<br />
4 Glenoid fossa<br />
6 Intermediate (central) thin zone<br />
9 Mandibular condyle (head)<br />
12 Posterior band of articular disc<br />
13 Posterior disc attachment
1 Anterior band of articular disc<br />
3 Articular tubercle (eminence)<br />
4 Glenoid fossa<br />
6 Intermediate (central) thin zone<br />
9 Mandibular condyle (head)<br />
12 Posterior band of articular disc
1 Anterior band of articular disc<br />
4 Glenoid fossa<br />
8 Lower head of lateral pterygoid muscle<br />
9 Mandibular condyle (head)<br />
12 Posterior band of articular disc<br />
15 Upper head of lateral pterygoid muscle
Periapical cyst, maxilla; 38-year-old male with some discomfort<br />
and swelling of mucobuccal fold;nonvital right<br />
lateral incisor. A Coronal <strong>CT</strong> image shows expansive<br />
process displacing part of nasal cavity, with intact and<br />
sclerotic border, occupying most of right maxillary sinus<br />
(arrow). B Axial <strong>CT</strong> image shows scalloped process<br />
destroying alveolar bone and hard palate (arrow)
Periapical cyst, maxilla; 58-year-old female with incidental<br />
finding at routine dental radiography, nonvital<br />
central incisor. Sagittal T1-weighted <strong>MRI</strong> shows oval<br />
expansive process with homogeneous high signal<br />
(arrow)
Periapical cyst, maxilla; 45-year-old female with incidental<br />
finding at routine dental radiography,<br />
nonvital lateral left incisor.A Panoramic view shows round<br />
process (more dense than air) with sclerotic<br />
border (arrows).
B Axial <strong>CT</strong> image shows expansive process<br />
(arrow) with intact sclerotic border<br />
in maxillary sinus (arrowhead
C Axial T2-weighted <strong>MRI</strong> shows high signal<br />
content (arrow) above<br />
intermediate signal content in dependent part;<br />
arrowhead fluid level.D Axial T1-weighted pre-gd<br />
<strong>MRI</strong> shows homogeneous intermediate signal<br />
(arrow). E Axial T1-weighted post-Gd <strong>MRI</strong> shows<br />
no enhancement except a thin peripheral rim<br />
(arrow
Periapical cyst, maxilla; 13-year-old female with painless<br />
swelling of mucobuccal fold and nonvital left lateral<br />
incisor, with previous pain from incisor. A Panoramic<br />
view shows radiolucency with partially sclerotic border<br />
in alveolar process around left lateral incisor and lack of<br />
sinus demarcation (arrow), and deviation of central incisor<br />
and canine.
B Coronal <strong>CT</strong> image shows expansive<br />
process with sclerotic border around incisor (arrow).<br />
C Coronal <strong>CT</strong> image shows process occupying most of<br />
maxillary sinus with a very thin sclerotic border (arrow).
D Coronal STIR <strong>MRI</strong> shows<br />
homogeneous high signal<br />
content (arrow). E Coronal T1weighted<br />
post-Gd <strong>MRI</strong><br />
shows no enhancement except<br />
peripheral rim (arrow).<br />
F Coronal T1-weighted post-Gd <strong>MRI</strong><br />
shows rim of enhancement<br />
and displacement of teeth (arrow)
Follicular cyst, maxilla; 8-year-old male with<br />
incidental finding when examined for an<br />
unerupted lateral incisor. A Panoramic view<br />
shows radiolucency and two unerupted<br />
teeth (arrow).
B Coronal <strong>CT</strong> image shows<br />
process with sclerotic border (arrow) around<br />
crown of canine (asterisk).C Coronal STIR <strong>MRI</strong><br />
shows homogeneous high signal content<br />
(arrow).
Follicular cyst, mandible; 38-year-old female with<br />
incidental finding at routine dental radiography.<br />
A Panoramic view shows radiolucency with sclerotic<br />
border around crown of impacted third molar, and root<br />
resorption of molars (arrow).
. B Axial <strong>CT</strong> image shows<br />
process with intact cortical bone (arrow) and part of impacted<br />
third molar. C Oblique coronal <strong>CT</strong> image shows<br />
process around crown of third molar with intact cortical<br />
bone expanding lingually (arrow) and buccally.
D Axial<br />
T2-weighted <strong>MRI</strong> shows heterogeneous signal<br />
content;<br />
homogeneous high signal in one part and<br />
heterogeneous<br />
low to intermediate signal close to impacted<br />
tooth (arrow). E Axial T1-weighted pre-Gd <strong>MRI</strong> shows<br />
homogeneous intermediate signal content (except<br />
small area close to impacted tooth) (arrow). F Axial<br />
T1-weighted post-Gd <strong>MRI</strong> shows no contrast<br />
enhancement<br />
(arrow)
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