RT Journal Article
SR Electronic
T1 Lumbar Facet Joint Synovial Cysts: Does T2 Signal Intensity Predict Outcomes after Percutaneous Rupture?
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1661
OP 1664
DO 10.3174/ajnr.A3441
VO 34
IS 8
A1 S.C. Cambron
A1 J.J. McIntyre
A1 S.J. Guerin
A1 Z. Li
A1 D.A. Pastel
YR 2013
UL http://www.ajnr.org/content/34/8/1661.abstract
AB BACKGROUND AND PURPOSE: Lumbar facet synovial cysts are a cause of back pain and radiculopathy with facet joint degeneration, the most common cause for cyst formation. Typically, LFSCs are T2 hyperintense on MR imaging, but the signal intensity is variable. Treatment options include percutaneous rupture and surgical resection. This study evaluates the relationship between LFSC signal intensity on MR imaging and outcomes as it relates to percutaneous rupture success and need for subsequent surgery. MATERIALS AND METHODS: A retrospective review of 110 patients who underwent CT fluoroscopic-guided rupture of symptomatic LFSCs was performed. The LFSCs were characterized by their T2 signal intensity on MR imaging and divided into 3 groups: high, intermediate, and low T2 signal intensity. The rates of successful cyst rupture and need for subsequent surgery were recorded. RESULTS: Percutaneous LFSC rupture was technically successful in 87% of all cases. Cyst rupture was successful in 89% and 90% of high and intermediate signal intensity cysts, respectively, and in 65% of low signal intensity cysts (P = .017, .030). High signal intensity cysts had lower postprocedural surgical rates (29%) when compared with intermediate and low signal cyst as a group (P = .045). CONCLUSIONS: T2 hyperintense and intermediate signal intensity LFSCs are easier to rupture, perhaps because the cysts contain a higher proportion of fluid and are less gelatinous or calcified than T2 hypointense cysts. Patients with T2 hyperintense LFSCs are less likely to need surgery. LFSClumbar facet synovial cyst