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Figure 23. Transverse T1 weighted spin echo image at the level of the root apices in the mandible. There is an area of reduced signal from the medullary bone inthe region of the right canine and premolar root apices, suggesting a more cystic nature. This is lower signal than muscle. The short tau inversion recovery (STIR) fat annulling sequence relating to this same area showed high signal around and below the apex of the lower first premolar, indicative of a lesion with high water and protein content. This agreed with the radiological and clinical findings that this was a periapical granuloma or cyst relating to the lower right first premolar with localized osteitic reaction in the surrounding medullary bone. The infected cyst later discharged through the buccal plate and the tooth was successfully treated endodontically.
