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Table 2: Imaging findings of IOVM and common lesions in the differential diagnosis
Diagnosis CT Findings MR Imaging Findings
IOVM Expansile and well-circumscribedCortex intact, but thin/scallopedStippled internal trabeculae, or,Honeycomb/spoke wheel ossification T2-very hyperintense, with internal stippled or striated signal voidT1 signal varies, thrombus may be brightT1 + gadolinium–avid enhancement
Intraosseous meningioma Dense marrow sclerosis and shaggy cortical hyperostosisExtraosseous soft tissue T2 intermediateT1 + gadoliniumIntraosseous: ± enhancementExtraosseous: avid plaquelike enhancement
Fibrous dysplasia Ground-glass matrix, ± cystic or more sclerotic elements T2 low-intermediate signal, though varies depending on cystic changeT1 + gadolinium: avid enhancement
Metastasis, myeloma No matrixCortical lysisMultiplicity Variable, depending on primary tumor
Lymphoma No matrixHyperdense soft tissue T2 intermediate, T1 + gadolinium: bland enhancementDiffusion-restriction, hypercellularity
Chondrosarcoma Rings/whorls of calcified matrixClassic location, petroclival T2 marked hyperintensityEnhancement, variable but often mild
Epidermoid cyst Low densityNo internal matrix T1-hypointense, T2-hyperintenseDiffusion restrictionNo internal enhancement