Magnetic resonance imaging (MRI) and dynamic MRI evaluation of extranodal non-Hodgkin lymphoma in oral and maxillofacial regions.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic value of magnetic resonance imaging (MRI), especially dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), in extranodal non-Hodgkin lymphoma (NHL) of oral and maxillofacial regions. STUDY DESIGN: Thirteen cases with extranodal NHL were examined using MRI. T1-weighted images (T1WI) and T2-weighted images (T2WI) or short TI inversion recovery (STIR) images were obtained in all cases. Contrast-enhanced images and DCE-MRI were acquired in 10 and 7 cases, respectively. On DCE-MRIs, we analyzed the parameters as follows: contrast index at maximal contrast enhancement (CImax), maximum contrast index (CI) gain/CImax ratio, and washout ratios (WR(300), WR(600), and WR(900)) at 300, 600, and 900 seconds after contrast medium injection. RESULTS: The signal intensity of all lesions was hypointense to isointense on T1WIs and showed variable contrast enhancement patterns. On T2WIs and STIR images, the signal intensity was isointense to hyperintense in almost all cases. Analysis of DCE-MRI parameters in extranodal NHLs resulted in the identification of 4 types of CI curves according to CImax and WR: (1) CImax greater than 2.0 and WR(900) greater than 40%, (2) CImax greater than 2.0 and WR(900) less than 40%, (3) CImax less than 1.5 and WR(900) greater than 40%, and (4) CImax less than 1.5 and WR(900) greater than 40%. CONCLUSIONS: The signal intensities on MRI were not specific to extranodal NHL and resembled those of other tumor types. When CImax was less than 1.5 or WR900 was less than 40%, these parameters contributed to diagnosis in extranodal NHLs.

Diagnostic value of dynamic contrast-enhanced MRI for submucosal palatal tumors.

OBJECTIVES: To evaluate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) for differentiating between benign and malignant tumors in the palate. MATERIALS AND METHODS: 26 patients with submucosal palatal tumors were preoperatively examined using DCE-MRI. Their maximum contrast index (CImax), time of CImax (Tmax), and washout ratios (WR300 and WR600) were determined from contrast index curves. The submucosal palatal tumors were divided into two groups according to their Tmax values: the early enhancement group (Tmax<300 s) consisted of 9 malignant tumors and 6 benign tumors, while the late enhancement group (Tmax≥300 s) included one malignant tumor and 10 benign tumors. We compared the following DCE-MRI parameters between the benign and malignant tumors: CImax and Tmax in all cases and CImax, Tmax, and the washout ratios in the early enhancement group. In addition, we performed a regression analysis of the relationships between tumor size and DCE-MRI parameters; i.e., CImax, Tmax, and washout ratios, among the malignant salivary gland tumors and pleomorphic adenomas. RESULTS: In all cases and the early enhancement group, significant differences in Tmax were detected between the benign and malignant tumors (P<0.001 and P<0.05, respectively), and the optimal Tmax cutoff value for differentiating between them was found to be 165 s. None of the other parameters displayed significant differences between the benign and malignant tumors. Only the WR600 of the pleomorphic adenomas was significantly correlated with tumor size (R2=0.92, P<0.001). CONCLUSIONS: Tmax is a useful parameter for distinguishing between benign and malignant submucosal palatal tumors.

Minor salivary gland tumors in the oral cavity: diagnostic value of dynamic contrast-enhanced MRI.

OBJECTIVE: To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for minor salivary gland tumors in the oral cavity. MATERIALS AND METHODS: Thirty-two patients with minor salivary gland tumors were examined preoperatively using DCE-MRI. Their maximum contrast index (CImax), time of CImax (Tmax), Tpeak; i.e., the time that corresponded to the CImax×0.90, and washout ratios (WR300 and WR600) were determined from contrast index (CI) curves. We compared these parameters between benign and malignant tumors and among the different histopathological types of minor salivary gland tumors. Then, we categorized the patients' CI curves into four patterns (gradual increase, rapid increase with high washout ratio, rapid increase with low washout, and flat). RESULTS: Statistically significant differences in Tmax (P=0.004) and Tpeak (P=0.002) were observed between the benign and malignant tumors. Regarding each histopathological tumor type, significant differences in Tmax (P<0.001), Tpeak (P<0.001), and WR600 (P=0.026) were observed between the pleomorphic adenomas and mucoepidermoid carcinomas. It was difficult to distinguish between benign and malignant tumors using our CI curve classification because that two-thirds of the cases were classified into the same type (gradual increase). CONCLUSION: The DCE-MRI parameters of minor salivary gland tumors contributed little to their differential diagnosis compared with those for major salivary gland tumors. During the diagnosis of minor salivary gland tumors, Tmax is useful for distinguishing between benign and malignant tumors.

Primary extranodal lymphoma of the maxilla: a case report with imaging features and dynamic data analysis of magnetic resonance imaging.

Malignant lymphoma is the second-most common malignancy in the head and neck region. Waldeyer's ring is the most common site of extranodal Hodgkin's lymphoma (NHL) in that region, and a small percentage of primary extranodal NHL occurs in the oral cavity. The most common sites of extranodal NHL in the oral region are the palate and maxilla, and nearly half of extranodal NHL cases arise from bone. It is difficult to diagnose extranodal NHL because of the variety of its radiological features. We report a case of primary extranodal NHL of the maxilla in a 68-year-old female patient with atypical imaging findings, along with the results of analysis of dynamic magnetic resonance imaging (MRI).

Ameloblastic carcinoma: a case report with radiological features of computed tomography and magnetic resonance imaging and positron emission tomography.

Ameloblastic carcinoma is a rare malignant odontogenic carcinoma that has metastatic potential, and because of its rare incidence, there are few reports focusing on its radiologic imaging. If it shows aggressive appearances, it can be diagnosed as malignant tumor. But in case of negative appearance, it is difficult to distinguish ameloblastic carcinoma from ameloblastoma. We report a case of ameloblastic carcinoma of the maxilla in a 76-year-old female patient with radiologic images and pathologic features.

Diagnostic value of dynamic contrast-enhanced MRI for unilocular cystic-type ameloblastomas with homogeneously bright high signal intensity on T2-weighted or STIR MR images.

Typical MR images of ameloblastomas on T2-weighted image (WI) or short inversion time inversion-recovery (STIR) show multiple bright high-signal-intensity loci on a high-signal-intensity background. Unilocular cystic-type ameloblastomas show homogeneously bright high signal intensity on T2WI or STIR as a water-like signal intensity. Therefore, it is difficult to distinguish unilocular cystic-type ameloblastoma from other cystic lesions such as keratocystic odontogenic tumors, radicular cysts (residual cysts) and dentigerous cysts only on the basis of MRI signal intensity. In the present study, we evaluated whether contrast-enhanced (CE)-T1WI and dynamic CE-MRI (DCE-MRI) could provide additional information for differential diagnosis in unilocular cystic-type ameloblastoma. Images from 12 cases of suspected unilocular cystic-type ameloblastoma were evaluated in the present study. Of them, 5 had areas suspected of indicating a solid component on T1WI and T2WI (or STIR). Ten had undergone additional CE-T1WI and DCE-MRI. On 5 of 10 cases of CE-T1WI, a tiny enhancement area was detected. On 6 of 10 DCE-images, a time-course enhanced area which was suspected to be a solid component was detected. CE-T1WI was helpful in the diagnosis of ameloblastoma because the tiny enhanced areas were taken to indicate possible solid components. Moreover, the rim-enhancement area on CE-T1WI could be divided into small regions of interest, and some of these showed slightly increased enhancement on DCE-MRI, which was taken to indicate a solid component and/or intramural nodule with focal invasion of ameloblastoma tissue. DCE-MRIs of the four remaining cases, which provided no clues to the diagnosis of ameloblastoma in the manner of the above descriptions, showed thicker rim enhancement than odontogenic cysts. Thus, CE-T1WI and DCE-MRI were helpful in the differential diagnosis of unilocular cystic-type ameloblastomas with homogeneously bright high signal intensity on T2WI or STIR.

Usefulness of MRI and dynamic contrast-enhanced MRI for differential diagnosis of simple bone cysts from true cysts in the jaw.

INTRODUCTION: It can be difficult to differentiate simple bone cysts (SBCs) from true cysts in the jaw when these lesions appear unilocular. The present study reports the MR imaging of subjects with SBCs and describes the diagnostic value of the MRI findings. MATERIALS AND METHODS: Ten subjects with SBCs in the jaw were examined using MRI. T1- and T2-weighted images (T1WI, T2WI) were obtained, and contrast-enhanced images and dynamic contrast-enhanced MRI (DCE-MRI) were acquired. RESULTS: In all cases, the contrast-enhanced T1WI acquired approximately 6 minutes after the administration of Gd-DTPA showed marked enhancement of the margin and slight enhancement of the inner part of the cyst cavity. In all cases, the time-signal intensity (SI) curves show a gradual increase in the SI until approximately 15 minutes after the administration of Gd-DTPA. These findings might not be observed on the DCE-MRIs of the other true cysts with epithelial lining that show no enhancement in a cavity. CONCLUSION: MRI, especially DCE-MRI, can provide useful information for distinguishing SBCs from other cysts.

Analysis of magnetic resonance images of disk positions and deformities in 1,265 patients with temporomandibular disorder.

OBJECTIVES: To compare MRI manifestations according to gender and age and to identify correlations between clinical manifestations and MRI findings in patients with temporomandibular disorder (TMD) as based on a large series. MATERIALS AND METHODS: Fat suppressed oblique sagittal images of the open and closed mouth were acquired, and MRI scanning parameters were applied. RESULTS: The patients consisted of 946 females (average, 36.6 years old), and 319 males (average, 34.3 years old). In all TMD patients, 945 had symptoms in the unilateral temporomandibular joint (TMJ) and 320 in the bilateral TMJ. There were significant differences in the distribution of disk positions based on age, regardless of gender, in the unilaterally and bilaterally symptomatic groups; however, the results were not significant in the asymptomatic group. There were significant differences with respect to the distribution of disk positions between males and females in asymptomatic group and in the unilaterally symptomatic group, although the bilaterally symptomatic group did not show significant differences in this regard. As regards the disk positions in the joints of the three groups (asymptomatic group, unilaterally and bilaterally symptomatic groups), there were significant interactive effects of disk positions, regardless of gender. There were statistically significant age-related differences in disk deformities in all symptom groups, regardless of gender, except for in the group of males lacking symptoms in either joint. As regards disk deformities among the three groups studies here, there were significant interactive effects for disk positions, regardless of gender.

Dynamic contrast-enhanced magnetic resonance imaging for estimating tumor proliferation and microvessel density of oral squamous cell carcinomas.

We evaluated the relationship between histopathological prognostic factors, tumor proliferation microvessel density (MVD), and enhancement parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in oral squamous cell carcinoma (SCC). Twenty-eight T2 and T3 patients with primary oral SCC underwent DCE-MRI using three-dimensional fast imaging with a steady-state precession sequence. Tumor cell proliferation and MVD of all surgical specimens were evaluated using immunohistochemical staining with CD34 and the antibody for proliferating cell nuclear antigen (PCNA). Regression analysis was used to statistically analyze the relationship between the PCNA labeling index or MVD and each of three DCE-MRI parameters: maximum CI (CI-max), maximum CI gain (CI-gain) and the CI-gain / CI-max ratio). The PCNA labeling index and MVD showed significant correlations with the CI-gain/CI-max ratio (P=0.0012, r=0.581 and P=0.00141, r=0.574, respectively). The assessment of DCE-MRI parameters may prove to be a valuable non-invasive method for assessing tumor cell proliferation and MVD of patients with oral cancer.

Novel cell-surface peptides specific to human oral squamous cell carcinoma using an E. coli peptide display library.

We attempted to find a specific antigen of oral squamous cell carcinoma (SCC) cells that could be safely applied to gene therapy in the conservative clinical treatment of oral cancer. We performed subtraction using normal human keratinocyte cells, followed by selection using four oral SCC cell lines. We isolated three clones from poorly differentiated SCC cells and four from well-differentiated SCC cells. These seven clones adsorbed to the oral SCC cells at rates 10-100 times those of normal human keratinocyte cells. The three clones from the poorly differentiated SCC cells showed the same peptide sequence (LAPRTHP). Of the four clones from the well-differentiated SCC cells, three showed the same peptide sequence (FGTLPGT) and the fourth showed a different one (VTPNSTP). Each peptide sequence may recognize the material that exists specifically on the oral SCC cell cortex. We can expect applications not only for tumor-targeting treatment using a gene therapy virus vector but also for diagnosis using, as a tumor marker, the peculiar SCC surface material that these peptides recognize.

Diagnostic value of dynamic contrast-enhanced MRI in the salivary gland tumors.

To evaluate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) in salivary gland tumors, thirty-five patients (47 lesions) who underwent MR examinations and were histopathologically diagnosed with salivary gland tumors in Okayama University Hospital, between April 1998 and March 2005, were entered in the present study. The parameters included CI(max300) or CI(max600), which was the contrast index (CI) at maximal contrast enhancement upon 300 s or 600 s, and Tmax, which was the time that corresponded to the CI(max300). Washout ratio (WR(300) or WR(600)) was defined as follows: CI(max300)-CI(300s)/CI(max300) or CI(max600)-CI(600s)/CI(max600)x100 (%), where CI(300) or CI(600) was the CI at 300s or 600s after contrast medium administration. We obtained the following results from the analysis of DCE-MRI parameters; (a) The salivary gland tumors were categorized into three CI curve types according to Tmax and WR300; Pleomorphic adenoma; Tmax > 210 s and WR300 < 10%, Warthin tumor; Tmax < 60 s and WR300 > 40%, and malignant tumor; 60s < Tmax < 210 s and 10% < WR300 < 30%; (b) On the basis of the relationship between Tmax and CImax or WR, all pleomorphic adenomas were successfully differentiated from Warthin tumor lesions. Of the 20 pleomorphic adenomas, 18 (90.0%) were successfully differentiated from malignant tumors. All Warthin tumor lesions were successfully differentiated from pleomorphic adenomas and malignant tumors. Of 12 the malignant tumors, 11 (91.7%) were successfully differentiated from pleomorphic adenomas. All malignant tumors were successfully differentiated from Warthin tumors. Thus, DCE-MRI parameters are useful in diagnosing salivary gland tumors on the basis of the combined assessment of Tmax and CImax or WR.

Enhancement effects of test injection with a small amount of MR contrast medium in the oral and maxillofacial region.

PURPOSE: To examine whether the signal intensity of dynamic contrast-enhanced MRI (DCE-MRI) is altered by test injection of 1 ml of contrast medium, and if so, whether this change affects the DCE-MRI analysis. MATERIALS AND METHODS: Six healthy volunteers were examined by DCE-MRI using a Magnevist syringe and/or an Omniscan syringe for the injection of contrast medium. Each scan was performed 10 times using steady-state free precession (3D-FISP), a sequence for DCE-MRI, before and after intravenous injection of 1 ml of the contrast medium. The internal pterygoid muscle, masseter muscle, tongue, parotid gland, submandibular gland, bone marrow of the mandible, subcutaneous adipose tissue, and common carotid artery were determined to be regions of interest (ROI), and the ROI internal average signal intensity was measured. The 10 data sets obtained before or after contrast medium administration for each ROI were evaluated using the paired t-test. RESULTS: The test injection increased the signal intensities of six of eight ROIs, with all 20 experiments in the submandibular gland showing significant differences. There was no significant difference in the two ROIs corresponding to the carotid artery and subcutaneous adipose tissue of the cheek. CONCLUSIONS: The enhanced signal intensity in the tissue might have been caused by the small amount of contrast medium in the test injection. To eliminate this discrepancy caused by the test injection, a pre-contrast scan should be performed when the average signal intensity of an ROI is measured. We therefore believe that the data obtained before a test injection may be important in the analysis of DCE-MRI.

Usefulness of contrast enhanced-MRI in the diagnosis of unicystic ameloblastoma.

The radiographic features of unicystic ameloblastoma (UA) are typically unilocular and round area of radiolucency. Therefore, this type of lesion is often misdiagnosed as an odontogenic keratocyst or a dentigerous cyst. UA should be differentiated from odontogenic cysts because the former have a higher rate of recurrence than the latter. In the present study, we performed contrast enhanced-MRI (CE-MRI) to diagnose 13 cases of unilocular, round radiolucent lesions visualized on panoramic radiograph and/or CT. In the cases of UA, low signal intensity was observed on T1-weighted images (WIs), and a markedly high signal intensity was observed on T2-WIs; moreover, relatively thick rim-enhancement with/without small intraluminal nodules was observed upon CE-T1WIs. CE-MRI was considered useful in the diagnosis of UA, as characteristic features of this type of lesion i.e., thick enhancement of the tumor wall and small intraluminal nodules were detected only by CE-MRI in the present study.

Assessment of ameloblastomas using MRI and dynamic contrast-enhanced MRI.

We retrospectively evaluated magnetic resonance images (MRI) and dynamic contrast-enhanced MRI (DCE-MRI) of ameloblastomas. MRI and DCE-MRI were performed for 10 ameloblastomas. We obtained the following results from the MRI and DCE-MRI. (a) Ameloblastomas can be divided into solid and cystic portions on the basis of MR signal intensities. (b) Ameloblastomas show a predilection for intermediate signal intensity on T1WI, high signal intensity on T2WI, and well enhancement in the solid portion; they also show a homogeneous intermediate signal intensity on T1WI and homogeneous high signal intensity on T2WI, and no enhancement in the cystic portion. (c) The mural nodule or thick wall can be detected in ameloblastomas lesions. (d) CI curves of ameloblastomas show two patterns: the first pattern increases, reaches a plateau at 100-300 s, then sustains the plateau or decreases gradually to 600-900 s, while the other increases relatively rapidly, reaches a plateau at 90-120 s, then decreases relatively rapidly to 300 s, and decreases gradually thereafter. There was no difference in the CI curve patterns among primary and recurrent cases, a case with glandular odontogenic tumor in ameloblastoma or among histopathological types such as plexiform, follicular, mixed, desmoplastic, and unicystic type.

Assessment of MRI and dynamic contrast-enhanced MRI in the differential diagnosis of adenomatoid odontogenic tumor.

The radiographical differentiation of adenomatoid odontogenic tumor (AOT) from dentigerous cysts, calcifying odontogenic cysts, calcifying epithelial odontogenic tumors, odontogenic keratocysts and amelobastomas is sometimes difficult. We attempted to differentiate AOT from other lesions similar to AOT in radiographic findings using MRI. The MRI features of AOT in our three cases included homogeneous low SI in the cystic portion and homogeneous intermediate SI in the solid portion on T1WI, homogeneous high SI in the cystic portion and intermediate to slightly high SI in the solid portion on T2WI and enhancement of only the solid portion on CE-T1WI although none of the sequences included SI of calcifications. The contrast index curves in the three cases of AOT showed a gradual increase to 300 s, which signified a benign tumor. These MRI features were characteristic features of AOT and might be a basis for differentiating AOT from the above possible lesions in radiographic examinations.

Application of dynamic contrast-enhanced MRI to differentiate malignant lymphoma from squamous cell carcinoma in the head and neck.

Because malignant lymphoma, the second most common malignant tumor of the head and neck, and squamous cell carcinoma (SCC), the most common malignant tumor of the head and neck, require different treatments, it is important to be able to differentiate them. In the present study, we attempted to differentiate malignant lymphomas from SCCs using dynamic contrast-enhanced MRI (DCE-MRI). Seventeen lesions (in 8 cases) of malignant lymphoma and 30 cases of SCC were compared by DCE-MRI. Thirteen of 17 malignant lymphomas (76.5%) showed the maximum contrast index (CI) at 90-180 s, while 26 of 30 SCCs (86.7%) showed the maximum CI at a much faster 60-105 s. There was a statistically significant difference between SCC and malignant lymphoma in the time needed reach the maximum CI (p = 0.0177). There was also significant difference between SCC and malignant lymphoma in their maximum CIs (p < 0.001), with the maximum CIs of 29/30 SCCs (96.7%) above 2.0, while 12/17 malignant lymphomas (70.6%) showed CIs of less than 2.0. We consider these findings to be useful for distinguishing lymphomas from SCCs.

MR imaging of epithelial cysts of the oral and maxillofacial region.

The aim of the present study was to review the magnetic resonance (MR) appearance of primary epithelial cysts in order to distinguish the cysts from other possible lesions. MR images were obtained in 27 cases of epithelial cysts, including 7 odontogenic keratocysts, 3 dentigerous cysts, 1 glandular odontogenic cyst, 10 radicular cysts, 4 nasopalatine duct cysts, and 2 nasolabial cysts. In addition, contrast enhanced MR imagings were performed in 12 cases, including 3 odontogenic keratocysts, 1 dentigerous cyst, 1 glandular odontogenic cyst, and 7 radicular cysts. We obtained the following results on the basis of the above MR and contrast enhanced MR findings. (a) Odontogenic keratocysts had a predilection for intermediate-high signal intensity (SI) on T1-weighted images (WI) and heterogeneous low-high SI on T2WI. (b) Dentigerous cysts, glandular odontogenic cyst, radicular cysts and nasolabial cysts showed the same predilection with the SI, which were homogeneous intermediate SI on T1WI and homogeneous high SI on T2WI. (c) The MR images of the nasopalatine duct cysts, which showed homogeneous high SI on T1WI, were specific. (d) The Gd-T1WI would be useful in decisively differentiating odontogenic cysts, which showed rim-enhancement, from tumors consisting of solid components. In conclusion, we were able to obtain more information from the MR and contrast enhanced MR images than from conventional radiograph findings.

The value of dynamic contrast-enhanced MRI in diagnosis of malignant lymphoma of the head and neck.

In this study, we attempted to diagnose malignant lymphoma on the basis of magnetic resonance imagings (MRIs) and dynamic contrast-enhanced MRI (DCE-MRI). Eighteen lesions (in eight patients), all of which had been proven histopathologically, were detected on MRI. The eight patients included five patients with diffuse large B-cell lymphoma, one with B-cell low-grade MALT lymphoma, one with follicular lymphoma, and one with Hodgkin's lymphoma. Nine lesions were located in the submandibular region, three in the buccal region, two in the orbit region, two in the submental region, and one each in the palatal and tonsil regions. The diameter of the lesions ranged between 9 and 42.2 mm (average: 22.4 mm). The signal intensities (SIs) of the 18 lesions were examined on T1-weighted (T1WI), T2WI, and gadopentetate (Gd)-T1WI. One lesion in case 8 was excluded from DCE-MRI findings, i.e., the regions of interest could not be adequately set on DCE-MRIs. The contrast index (CI) curves of the remaining 17 lesions were prepared. All 18 lesions showed almost the same images on T1WI, T2WI, and Gd-T1WI, although they represented four types of lymphoma. The images showed homogeneous SI that was intermediate to slightly high SI on T1WI, slightly high SI on T2WI, and moderately enhanced on Gd-T1WI. Thus, the cases of malignant lymphoma in this study showed relatively characteristic features based on MRI; however, these features might be non-specific. The CI curves in this study showed a relatively rapid increase, reaching a maximum CI at 45-120 s, and a relatively rapid decrease in most lesions (14/17; 82.4%); on the other hand, the curves of 3 of the 15 lesions (17.6%) showed relatively rapid increase, sustenance of a plateau, and a gradual decrease thereafter. These patterns of CI curves may indicate characteristic features useful for distinguishing malignant lymphomas from other lesions.

Assessment of pleomorphic adenomas using MRI and dynamic contrast enhanced MRI.

We evaluated magnetic resonance images (MRI) and the value of dynamic contrast enhanced MRI (DCE-MRI) of pleomorphic adenomas retrospectively. MRI was performed for 18 pleomorphic adenomas, including 11 cases with DCE-MRI. We obtained the following results on the MRI and DCE-MRI. (a). Pleomorphic adenomas showed a predilection for homogeneous intermediate signal intensity on T1-weighted images (T1WI), heterogeneous high signal intensity on T2-weighted images, and heterogeneous enhancement on Gd-T1WI. (b). Of 11 contrast index (CI) curves of pleomorphic adenomas, nine CI curves (81.8%) increased gradually to 600 s or increased gradually, reached a plateau, and sustained the plateau to 600 s. The remaining two (18.2%) increased gradually and decreased gradually thereafter. (c). CI curves reached the maximum CI index at 135-300 s.

Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis.

We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.