Conventional and Advanced MR Imaging Findings in a Cohort of Pathology-Proven Dermoid Cysts of the Pediatric Scalp and Skull

Authors

Bettina L Serrallach
Gunes Orman
M John Hicks
Nilesh Desai
Stephen Kralik
Thierry Agm Huisman

Publication Date

8-1-2022

Journal

The Neuroradiology Journal

DOI

10.1177/19714009211059120

PMID

34873956

PMCID

PMC9437494

PubMedCentral® Posted Date

12-7-2021

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Child, Child, Preschool, Dermoid Cyst, Female, Humans, Infant, Magnetic Resonance Imaging, Male, Retrospective Studies, Scalp, Skull, dermoid, scalp, skull, pediatric, magnetic resonance imaging, diffusion weighted imaging, apparent diffusion coefficient

Abstract

BACKGROUND: In the pediatric population, dermoid cysts are among the most frequent lesions of the scalp and skull. Imaging plays a key role in characterizing scalp and skull lesions in order to narrow the differential diagnoses. In general, dermoids are described as heterogeneous T1-/T2-hypo- to hyperintense lesions on magnetic resonance imaging.

METHODS: The goal of this retrospective study is to evaluate the diffusion weighted imaging findings while reviewing the conventional T1-/T2-/T1+C-weighted MR characteristics in a pathology-proven series of 14 dermoids of the pediatric scalp and skull.

RESULTS: In our pediatric cohort (eight boys, six girls, age range 3-95 months), half of the dermoids were homogeneous T1-hypointense and homogeneous T2-hyperintense. We found a mixture of restricted (45.5%) and increased diffusion (54.5%) in dermoids. The vast majority of dermoids (91.7%) showed rim enhancement. Most dermoids (57.1%) were located at the midline and adjacent to one of its sutures.

CONCLUSIONS: This study suggests that dermoids may have more variable imaging appearances than hitherto assumed and are frequently seen in close proximity or adjacent to the anterior fontanelle.