Differentiating odontogenic myxoma from ameloblastoma by focusing on cyst-like areas on MR images.
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OBJECTIVES: This study aimed to identify characteristic findings of odontogenic myxoma (OM) and assess the role of MRI in differentiating OM from ameloblastoma by analysing cyst-like areas. METHODS: MRI images from 12 and 15 patients with OM and ameloblastoma, respectively, were retrospectively evaluated to determine imaging features useful for differentiation. We analysed cyst-like areas in OM using apparent diffusion coefficient (ADC) values and gadolinium contrast patterns, comparing them with those in ameloblastoma. ADC values were statistically assessed via the Mann-Whitney U test. RESULTS: In OM, the mean ADC value of cyst-like areas was 1.84 × 10⁻3 mm2/s. Contrast-enhanced T1-weighted images showed signal enhancement, with a gradual increase on dynamic contrast-enhanced MRI (DCE-MRI). Conversely, in ameloblastoma, the mean ADC value was 2.28 × 10⁻3 mm2/s. Unlike OM, its cyst-like areas lacked enhancement, with only the solid areas exhibiting a rapid signal increase on DCE-MRI. ADC values were significantly higher in ameloblastoma (P < 0.05). CONCLUSIONS: The presence or absence of contrast enhancement in cyst-like areas aids in differentiating OM from ameloblastoma. Additionally, ADC values may be used to differentiate between these tumors in the absence of contrast agents.