Comparison of computed tomography and magnetic resonance imaging in evaluation of skull lesions

Background: Computed tomography (CT) and magnetic resonance imaging (MRI) have been incorporated into the basic imaging tools for evaluation of skull lesions. Despite the known advantages and disadvantages of CT and MRI in various aspects of evaluating skull lesions, it is not always feasible to perform both CT and MRI in evaluation of the same patient. The purpose of this study is to compare CT and MRI in evaluation of various skull lesions and to determine which imaging modality out of the two is more appropriate in evaluation of skull lesions and their characterization. Results: There was no statistically significant difference between CT and MRI for detection of number of lesions, distribution of lesions, margins of the lesions, nature of the lesions, zone of transition, cortical breach, intralesional calcification, intralesional hemorrhage, associated soft tissue, and invasion into brain parenchyma (p value > 0.05 in all these parameters). Dural involvement was picked up better on MRI as compared to CT (p value 0.031). Another advantage of MRI over CT was better characterization of lesions by diffusion weighted imaging. Conclusion: CT and MRI are equally efficient in providing adequate diagnostic information in various skull lesions and each of them can be used independent of the other to characterize and diagnose the lesions of skull. The slight advantage of MRI over CT is detection of dural involvement.