Maxillofacial Imaging Anatomy

CT AND MRI imaging

CT SCAN
Basic Principles
detectors

x-ray source

Instead of film, radiation detectors measure the radiation

attenuation as the beam passes through the body.
The detectors are connected to a computer that uses algorithms
to process the data into useful images that are then recorded
on film and viewed on a computer monitor.

7G: Multislice

Helical CT

79 Maxilla
81 Maxillary sinus
104B Nasal bone
106 Nasal septum
122 Perpendicular plate of
ethmoid bone

23 Frontal bone
24 Frontal process of maxilla
25 Frontal sinus
38 Incisive canal
42 Inferior turbinate
48 Lacrimal sac fossa
58 Mandible
149 Vomer

10 Concha bullosa
12 Crista galli
15 Ethmoid sinus
23 Frontal bone
25 Frontal sinus
34 Hard palate
38 Incisive canal
40 Inferior meatus
42 Inferior turbinate
43 Infraorbital canal

49 Lamina papyracea of
ethmoid
60 Mandibular canal 113 Orbit
62 Mandibular foramen
81 Maxillary sinus
99 Middle meatus
100 Middle turbinate
101 Middle suture of hard
palate
109 Nasolacrimal canal

15 Ethmoid sinus
30 Greater palatine canal
32 Greater wing of
sphenoid bone
41 Inferior orbital fissure
42 Inferior turbinate
49 Lamina papyracea of
ethmoid

60 Mandibular canal
100 Middle turbinate
115 Palatal recess of maxillary
sinus
122 Perpendicular plate of
ethmoid bone
144 Superior turbinate
151 Zygomatic arch

21 Foramen rotundum
36 Hyoid bone 133 Sphenoid
sinus
33 Hamulus of medial pterygoid
plate
51 Lateral pterygoid plate
134 Sphenoid sinus septum
64 Mandibular ramus

96 Medial pterygoid plate

60 Mandibular canal
125 Pterygoid fossa
133 Sphenoid sinus
151 Zygomatic arch

20 Foramen ovale
29 Glenoid fossa
36 Hyoid bone
64 Mandibular ramus
61 Mandibular condyle
114 Oropharynx
132 Sphenoid bone
133 Sphenoid sinus
148 Uvula

134 Sphenoid sinus septum

8 Carotid canal
9 Clivus
11 Coronoid process
15 Ethmoid sinus
23 Frontal bone
24 Frontal process of maxilla
41 Inferior orbital fissure
47 Lacrimal bone
49 Lamina papyracea of ethmoid
52 Lateral recess of sphenoid sinus
61 Mandibular condyle

81 Maxillary sinus
100 Middle turbinate
105 Nasal cavity airway
106 Nasal septum 132 Sphenoid
bone
109 Nasolacrimal canal
111 Olfactory recess 133
Sphenoid sinus
135 Sphenozygomatic suture
150 Zygoma
151 Zygomatic arch

11 Coronoid process
30 Greater palatine canal
40 Inferior meatus
42 Inferior turbinate
43 Infraorbital canal
51 Lateral pterygoid plate
53 Lesser palatine canal

63 Mandibular notch
61 Mandibular condyle
64 Mandibular ramus
96 Medial pterygoid plate
97 Medial wall of maxillary
sinus
109 Nasolacrimal canal
110 Nasopharynx
125 Pterygoid fossa
128 Pterygopalatine fossa

2 -Alveolar recess of
maxillary sinus
4 Anterior nasal spine
31 Greater palatine foramen
38 Incisive cana
34 Hard palate
39 Incisive foramen
51 Lateral pterygoid plate
53 Lesser palatine canal
63 Mandibular notch

64 Mandibular ramus
80 Maxillary alveolar bone
92 Maxillary tooth root
94 Maxillary tuberosity 81
Maxillary sinus
101 Middle suture of hard
palate
138 Styloid process
126 Pterygoid process of
sphenoid

39 Incisive foramen
60 Mandibular canal 62 Mandibular foramen
66 Mandibular tooth 1, central incisor
67 Mandibular tooth 2, lateral incisor
68 Mandibular tooth 3, canine
69 Mandibular tooth 4, first premolar
70 Mandibular tooth 5, second premolar
71 Mandibular tooth 6, first molar
72 Mandibular tooth 7, second molar
73 Mandibular tooth 8, third molar
74 Mandibular tooth crown pulp
80 Maxillary alveolar bone

83 Maxillary tooth 1, central incisor

84 Maxillary tooth 2, lateral incisor
85 Maxillary tooth 3, canine
86 Maxillary tooth 4, first premolar
87 Maxillary tooth 5, second premolar
88 Maxillary tooth 6, first molar
89 Maxillary tooth 7, second molar
91 Maxillary tooth crown pulp
93 Maxillary tooth root canal
126 Pterygoid process of sphenoid
130 Retromolar trigone

26 Genial process of mandible

59 Mandibular alveolar bone
60 Mandibular canal
71 Mandibular tooth 6, first molar
75 Mandibular tooth root
76 Mandibular tooth root canal
98 Mental foramen

37 Incisive artery canal

59 Mandibular alveolar bone
60 Mandibular canal
80 Maxillary alveolar bone
81 Maxillary sinus
94 Maxillary tuberosity

60 Mandibular canal

60 Mandibular canal
62 Mandibular foramen
37 Incisive artery canal

3 Anterior belly of digastric

muscle
6 Buccal space fat
7 Buccinator muscle
11 Coronoid process
27 Genioglossus muscle
28 Geniohyoid muscle
34 Hard palate
42 Inferior turbinate
58 Mandible
77 Masseter muscle

81 Maxillary sinus
100 Middle turbinate
103 Mylohyoid muscle
123 Platysma muscle
133 Sphenoid sinus
145 Temporalis muscle
146 Tongue, oral
151 Zygomatic arch

3 Anterior belly of digastric muscle

7 Buccinator muscle
11 Coronoid process
20 Foramen ovale
27 Genioglossus muscle
28 Geniohyoid muscle
35 Hyoglossus muscle
36 Hyoid bone
50 Lateral pterygoid muscle
55 Lingual septum
58 Mandible
61 Mandibular condyle
64 Mandibular ramus

77 Masseter muscle
95 Medial pterygoid muscle
102 Mylohyoid line (ridge)
103 Mylohyoid muscle
117 Parapharyngeal space
118 Parotid gland
123 Platysma muscle
131 Soft palate
132 Sphenoid bone
141 Submandibular gland
142 Submandibular space
145 Temporalis muscle
151 Zygomatic arch

4 Anterior nasal spine

6 Buccal space fat
11 Coronoid process
16 External auditory canal
22 Fossa of Rosenmller (lateral pharyngeal
fold)
34 Hard palate
44 Infratemporal fossa
50 Lateral pterygoid muscle
51 Lateral pterygoid plate
60 Mandibular canal
64 Mandibular ramus
77 Masseter muscle

78 Mastoid process
81 Maxillary sinus
95 Medial pterygoid muscle
96 Medial pterygoid plate
106 Nasal septum
107 Nasal vestibule
110 Nasopharynx
117 Parapharyngeal space
118 Parotid gland
124 Posterior belly of digastric
muscle
138 Styloid process
145 Temporalis muscle

3 Anterior belly of digastric

muscle
5 Base of tongue
14 Epiglottis
27 Genioglossus muscle
28 Geniohyoid muscle
35 Hyoglossus muscle
36 Hyoid bone
55 Lingual septum
58 Mandible

77 Masseter muscle
103 Mylohyoid muscle
123 Platysma muscle
137 Sternocleidomastoid
muscle
138 Styloid process
140 Sublingual space
141 Submandibular gland
142 Submandibular space

MRI

Basic Principles

POLARIZATION.
RESONANCE.
RELAXATION

The signal density:

Lesion

T1

T2

Mucosal
thickness
Cyst

Intermediate

High

Low

High

Serum

Low

High

Blood

High

High

The signal density:

Foreign body

Low

Low

Polyp

Low

Very high

Mucocele

High

High

3 Anterior belly of digastric

muscle
7 Buccinator muscle
15 Ethmoid sinus
25 Frontal sinus
27 Genioglossus muscle
28 Geniohyoid muscle
42 Inferior turbinate
60 Mandibular canal
65 Mandibular tooth
81 Maxillary sinus
82 Maxillary tooth

100 Middle turbinate

103 Mylohyoid muscle
106 Nasal septum
113 Orbit
123 Platysma muscle
139 Sublingual gland
140 Sublingual space
146 Tongue, oral

6 Buccal space fat

11 Coronoid process
27 Genioglossus muscle
35 Hyoglossus muscle
55 Lingual septum
77 Masseter muscle
103 Mylohyoid muscle
142 Submandibular space
145 Temporalis muscle
146 Tongue, oral
151 Zygomatic arch

1 Adenoidal tissue
(nasopharyngeal tonsil)
11 Coronoid process
19 Facial vein
42 Inferior turbinate
50 Lateral pterygoid muscle
54 Levator labii superioris
muscle
61 Mandibular condyle

77 Masseter muscle
81 Maxillary sinus
95 Medial pterygoid muscle
104 Nasal ala
106 Nasal septum
145 Temporalis muscle
147 Torus tubarius
151 Zygomatic arch

11 Coronoid process

15B Eustachian tube

22 Fossa of Rosenmller
(lateral pharyngeal fold)
42 Inferior turbinate
44 Infratemporal fossa
45 Internal carotid artery
47 Lacrimal bone
50 Lateral pterygoid muscle
56 Longus colli muscle
61 Mandibular condyle
64 Mandibular ramus

77 Masseter muscle
78 Mastoid process
81 Maxillary sinus
106 Nasal septum
110 Nasopharynx
117 Parapharyngeal space
118 Parotid gland
145 Temporalis muscle

6 Buccal space fat

7 Buccinator muscle
13 Dens axis
19 Facial vein
45 Internal carotid artery
46 Internal jugular vein
50 Lateral pterygoid muscle
56 Longus colli muscle
57 Major zygomatic muscle
64 Mandibular ramus
77 Masseter muscle

95 Medial pterygoid muscle

112 Orbicularis oris muscle
118 Parotid gland
119 Parotid gland, accessory
120 Parotid gland, deep lobe
121 Parotid gland, superficial
lobe
136 Stensens duct
148 Uvula

5 Base of tongue
13 Dens axis
28 Geniohyoid muscle
45 Internal carotid artery
46 Internal jugular vein
77 Masseter muscle
95 Medial pterygoid
muscle
116 Palatine tonsil

118 Parotid gland

124 Posterior belly of digastric
muscle
127 Pterygomandibular space
129 Retromandibular vein
130 Retromolar trigone
148 Uvula

28 Geniohyoid muscle
35 Hyoglossus muscle
77 Masseter muscle
103 Mylohyoid muscle
116 Palatine tonsil
118 Parotid gland
139 Sublingual gland
140 Sublingual space

3 Anterior belly of digastric muscle

28 Geniohyoid muscle
35 Hyoglossus muscle
45 Internal carotid artery
46 Internal jugular vein
56 Longus colli muscle
58 Mandible
141 Submandibular gland
142 Submandibular space

3 Anterior belly of digastric

muscle
14 Epiglottis
17 External carotid artery
18 External jugular vein
45 Internal carotid artery
46 Internal jugular vein
103 Mylohyoid muscle
123 Platysma muscle
137 Sternocleidomastoid muscle
141 Submandibular gland
143 Submental space

1 Anterior band of articular disc)

2 Articular disc
4 Glenoid fossa
5 Inferior joint space
6 Intermediate (central) thin zone
7 Lateral pterygoid muscle raphe

8 Lower head of lateral pterygoid muscle

9 Mandibular condyle (head)
12 Posterior band of articular disc
13 Posterior disc attachment
14 Superior joint space
15 Upper head of lateral pterygoid muscle

1 Anterior band of articular disc

3 Articular tubercle (eminence)
4 Glenoid fossa
6 Intermediate (central) thin zone
7 Lateral pterygoid muscle raphe

8 Lower head of lateral pterygoid

9 Mandibular condyle (head)
12 Posterior band of articular disc
13 Posterior disc attachment
15 Upper head of lateral pterygoid muscle

1 Anterior band of articular disc

4 Glenoid fossa
6 Intermediate (central) thin zone
9 Mandibular condyle (head)
12 Posterior band of articular disc
13 Posterior disc attachment

1 Anterior band of articular disc

3 Articular tubercle (eminence)
4 Glenoid fossa
6 Intermediate (central) thin zone
9 Mandibular condyle (head)
12 Posterior band of articular disc

1 Anterior band of articular disc

4 Glenoid fossa
8 Lower head of lateral pterygoid muscle
9 Mandibular condyle (head)
12 Posterior band of articular disc
15 Upper head of lateral pterygoid muscle

Periapical cyst, maxilla; 38-year-old male with some discomfort

and swelling of mucobuccal fold;nonvital right
lateral incisor. A Coronal CT image shows expansive
process displacing part of nasal cavity, with intact and
sclerotic border, occupying most of right maxillary sinus
(arrow). B Axial CT image shows scalloped process
destroying alveolar bone and hard palate (arrow)

Periapical cyst, maxilla; 58-year-old female with incidental

finding at routine dental radiography, nonvital
central incisor. Sagittal T1-weighted MRI shows oval
expansive process with homogeneous high signal
(arrow)

Periapical cyst, maxilla; 45-year-old female with incidental

finding at routine dental radiography,
nonvital lateral left incisor.A Panoramic view shows round
process (more dense than air) with sclerotic
border (arrows).

B Axial CT image shows expansive process

(arrow) with intact sclerotic border
in maxillary sinus (arrowhead

C Axial T2-weighted MRI shows high signal

content (arrow) above
intermediate signal content in dependent part;
arrowhead fluid level.D Axial T1-weighted pre-gd
MRI shows homogeneous intermediate signal
(arrow). E Axial T1-weighted post-Gd MRI shows
no enhancement except a thin peripheral rim
(arrow

Periapical cyst, maxilla; 13-year-old female with painless

swelling of mucobuccal fold and nonvital left lateral
incisor, with previous pain from incisor. A Panoramic
view shows radiolucency with partially sclerotic border
in alveolar process around left lateral incisor and lack of
sinus demarcation (arrow), and deviation of central incisor
and canine.

B Coronal CT image shows expansive

process with sclerotic border around incisor (arrow).
C Coronal CT image shows process occupying most of
maxillary sinus with a very thin sclerotic border (arrow).

D Coronal STIR MRI shows

homogeneous high signal
content (arrow). E Coronal T1weighted post-Gd MRI
shows no enhancement except
peripheral rim (arrow).
F Coronal T1-weighted post-Gd MRI
shows rim of enhancement
and displacement of teeth (arrow)

Follicular cyst, maxilla; 8-year-old male with

incidental finding when examined for an
unerupted lateral incisor. A Panoramic view
shows radiolucency and two unerupted
teeth (arrow).

B Coronal CT image shows

process with sclerotic border (arrow) around
crown of canine (asterisk).C Coronal STIR MRI
shows homogeneous high signal content
(arrow).

Follicular cyst, mandible; 38-year-old female with

incidental finding at routine dental radiography.
A Panoramic view shows radiolucency with sclerotic
border around crown of impacted third molar, and root
resorption of molars (arrow).

. B Axial CT image shows

process with intact cortical bone (arrow) and part of impacted
third molar. C Oblique coronal CT image shows
process around crown of third molar with intact cortical
bone expanding lingually (arrow) and buccally.

D Axial
T2-weighted MRI shows heterogeneous signal
content;
homogeneous high signal in one part and
heterogeneous
low to intermediate signal close to impacted
tooth (arrow). E Axial T1-weighted pre-Gd MRI shows
homogeneous intermediate signal content (except
small area close to impacted tooth) (arrow). F Axial
T1-weighted post-Gd MRI shows no contrast
enhancement
(arrow)