Central vascular malformations of the mandible: characteristic findings in computed tomography and magnetic resonance imaging

Central vascular malformations (CVMs) of the mandible are rare and can have varied clinical and radiological characteristics, thus making differential diagnosis difficult. We retrospectively reviewed 5 patients with proven CVM who underwent computed tomography (CT) and magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) (and magnetic resonance angiography (MRA) for one patient), to assess the characteristic imaging findings of this lesion. CT revealed multilocularity in 3 lesions. All CVMs produced fine, irregular borders and low-to-intermediate density. Lesion continuity with the mandibular canal was discovered in 4 cases and enlarged feeding and outflow vessels in 3 lesions. Bone overgrowth was observed in 2 patients. CT values ranged from 30.84 to 52.87 Hounsfield units (HU). MRI exhibited low to intermediate signals on T1-weighted imaging (T1WI), signals ranging from low to intermediate-to-high on T2WI, and low to high signal intensity on short-tau inversion recovery (STIR) images, with flow voids in all patients and no inflammation in surrounding tissues. As calculated with DWI, the apparent diffusion coefficient (ADC) ranged from 0.69 to 1.74 & POUND; 10-3 mm2/s. MRA showed the presence of feeding vessels in 1 lesion. Interexaminer agreement on image interpretation ranged from moderate to excellent. These typical CVM imaging findings may aid in the differential diagnosis of this lesion. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;135:e123-e130)