Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Preece, M.T. Articles by Smirniotopoulos, J.G. Search for Related Content PubMed PubMed Citation Articles by Preece, M.T. Articles by Smirniotopoulos, J.G.

American Journal of Neuroradiology 27:1211-1216, June-July 2006
© 2006 American Society of Neuroradiology

BRAIN

Intracranial Neurenteric Cysts: Imaging and Pathology Spectrum

M.T. Preece^a, A.G. Osborn^a, S.S. Chin^b and J.G. Smirniotopoulos^c

^a Department of Radiology, University of Utah, Salt Lake City, Utah
^b Department of Pathology, University of Utah, Salt Lake City, Utah
^c Department of Radiology and Nuclear Medicine, Uniformed Services University, Bethesda, Md

Address correspondence to Michael T. Preece, MD, 129 Franklin St, Apt 140, Cambridge, MA 02139

BACKGROUND AND PURPOSE: Intracranial neurenteric (NE) cysts are rare congenital lesions that may be mistaken for other, more common non-neoplastic cysts as well as cystic neoplasms. We delineate the imaging spectrum, pathologic findings, and differential diagnosis of NE cysts.

METHODS: History, imaging, surgical and pathologic findings were analyzed retrospectively in 18 patients with intracranial NE cysts. Fifteen were surgically proved cases; 3 exhibited classic imaging findings and are being followed clinically.

RESULTS: Thirteen cysts were located in the posterior fossa; 12 of 13 were extra-axial. Size varied from 1.2 x 0.8 x 0.6 cm to 3.4 x 3 x 2.5 cm. Five were supratentorial, measuring from 7 x 5 x 3 to 9 x 6 x 7 cm. All were frontal and off the midline. Seven of 18 patients had CT scans. Cysts varied widely in attenuation. None enhanced. Eighteen of 18 had MR images. Sixteen of 18 were hyperintense, and 2 were isointense to CSF on T1-weighted imaging. Sixteen of 18 were hyperintense on T2-weighted imaging. All cysts were hyperintense to CSF on fluid-attenuated inversion recovery (FLAIR) sequences. Diffusion imaging was performed on 2 patients. One case showed mild restriction. Mild posterior rim enhancement was seen in 5 cases at the site where the cyst adhered to brain parenchyma.

CONCLUSION: The imaging spectrum for NE cysts is broader than previously reported. Intracranial NE cysts should be considered in the differential diagnosis for intracranial extra axial cystic lesions both above and below the tentorium.