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Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful?

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Abstract

Background

Appropriate differentiation between epidermoid-dermoid and arachnoid cysts is important for patient management. MRI has had limitations in differentiating these two types of cysts, especially in the region of the spinal cord.

Objective

To evaluate the role of diffusion-weighted (DW) MRI for differentiation between spinal arachnoid and epidermoid-dermoid cysts.

Materials and methods

Four children underwent conventional and DW MRI. Turbo spin-echo imaging was used to obtain DW images.

Results

On conventional MRI, low T1-W and high T2-W signal was present in all lesions. DW imaging showed restricted diffusion in two patients with epidermoid-dermoid cysts and no water restriction in two patients with arachnoid cysts. Three of four children had extramedullary lesions and one patient had an intramedullary lesion. Three children had surgery, two with epidermoid-dermoid cysts and one with arachnoid cyst. Diagnosis was confirmed by histopathology. One child with a thoracic arachnoid cyst had stable clinical imaging findings during a follow-up of 21 months.

Conclusion

On conventional MRI, epidermoid-dermoid and arachnoid cysts have similar signal characteristics. Initial experience with spine DW imaging shows promise in differentiating epidermoid-dermoid cysts from arachnoid cysts. Preoperative differentiation is important because it changes management and surgical approach.

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References

  1. Kuzma BB, Goodman JM (1997) Epidermoid or arachnoid cyst? Surg Neurol 47:395–396

    Article  PubMed  CAS  Google Scholar 

  2. Bourekas EC, Raji MR, Dastur KJ et al (1992) Retroclival arachnoid cyst. AJNR 13:353–354

    PubMed  CAS  Google Scholar 

  3. Gandy SE, Heier LA (1987) Clinical and magnetic resonance features of primary intracranial arachnoid cyst. Ann Neurol 21:342–348

    Article  PubMed  CAS  Google Scholar 

  4. Tampieri D, Melanson D, Either R (1989) MR imaging of epidermoid cysts. AJNR 10:351–356

    PubMed  CAS  Google Scholar 

  5. Takahashi S, Morikawa S, Egawa M et al (2003) Magnetic resonance imaging-guided percutaneous fenestration of a cervical intradural cyst: case report. J Neurosurg 99(3 Suppl):313–315

    PubMed  Google Scholar 

  6. Tsuruda JS, Chew WM, Moseley ME et al (1990) Diffusion-weighted MR imaging of the brain: value of differentiating between extra-axial cysts and epidermoid tumors. AJR 155:1059–1065

    PubMed  CAS  Google Scholar 

  7. Dutt SN, Mirza S, Chavda SV et al (2002) Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otol Neurotol 23:84–92

    Article  PubMed  Google Scholar 

  8. Laing AD, Mitchell PJ, Wallace D (1999) Diffusion-weighted magnetic resonance imaging of intracranial epidermoid tumors. Australas Radiol 43:16–19

    Article  PubMed  CAS  Google Scholar 

  9. Avellino AM, Mesiwala AB, Shaw DW et al (2001) Diffusion-weighted magnetic resonance image of a pediatric spinal epidermoid cyst. Pediatr Neurosurg 34:325–326

    Article  PubMed  CAS  Google Scholar 

  10. Teksam M, Casey SO, Michel E et al (2001) Intraspinal epidermoid cyst: diffusion-weighted MRI. Neuroradiology 43:572–574

    Article  PubMed  CAS  Google Scholar 

  11. Kikuchi K, Miki H, Nakagawa A (2000) The utility of diffusion-weighted imaging with navigator-echo technique for the diagnosis of spinal epidermoid cysts. AJNR 21:1164–1166

    PubMed  CAS  Google Scholar 

  12. Roux A, Mercier C, Larbrisseau A et al (1992) Intramedullary epidermoid cysts of the spinal cord: case report. J Neurosurg 76:528–533

    PubMed  CAS  Google Scholar 

  13. Halcrow SJ, Crawford PJ, Craft AW (1985) Epidermoid spinal cord tumor after lumbar puncture. Arch Dis Child 60:978–979

    PubMed  CAS  Google Scholar 

  14. Manno NJ, Uihlein A, Kernohan JW (1962) Intraspinal epidermoids. J Neurosurg 19:754–765

    PubMed  CAS  Google Scholar 

  15. Shaywitz BA (1972) Epidermoid spinal cord tumors and previous lumbar punctures. J Pediatr 80:638–640

    Article  PubMed  CAS  Google Scholar 

  16. Van Gilder JC, Schwartz HG (1967) Growth of dermoids from skin implants to the nervous system and surrounding spaces of the newborn rat. J Neurosurg 26:14–20

    PubMed  Google Scholar 

  17. Rabb CH, McComb JG, Raffel C et al (1992) Spinal arachnoid cysts in the pediatric age group: an association with neural tube defects. J Neurosurg 77:369–372

    PubMed  CAS  Google Scholar 

  18. Go KG, Houthoff HJ, Blaauw EH et al (1984) Arachnoid cysts of the Sylvian fissure: evidence of fluid secretion. J Neurosurg 60:803–813

    PubMed  CAS  Google Scholar 

  19. Santamarta D, Aguas J, Ferrer E (1995) The natural history of arachnoid cysts. Endoscopic and cine-mode MRI evidence of a slit-valve mechanism. Minim Invasive Neurosurg 38:133–137

    Article  PubMed  CAS  Google Scholar 

  20. Bammer R, Fazekas F (2003) Diffusion imaging of the human spinal cord and the vertebral column. Top Magn Reson Imaging 14:461–476

    Article  PubMed  Google Scholar 

  21. Gottfried ON, Rao G, Anderson RC et al (2005) Diffusion restriction of a spinal arachnoid cyst: case illustration. J Neurosurg 102(4 Suppl):439

    PubMed  Google Scholar 

  22. Osenbach RK, Godersky JC, Traynelis VC et al (1992) Intradural extramedullary cysts of the spinal canal: clinical presentation, radiographic diagnosis, and surgical management. Neurosurgery 30:35–42

    Article  PubMed  CAS  Google Scholar 

  23. Jensen F, Knudsen V, Troelsen S (1977) Recurrent intraspinal arachnoid cyst treated with a shunt procedure. Acta Neurochir (Wien) 39:127–129

    Article  CAS  Google Scholar 

  24. Wang MY, Levi AD, Green BA (2003) Intradural spinal arachnoid cysts in adults. Surg Neurol 60:49–55

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Miami Children’s Hospital, 3100 SW 62nd Ave, Miami, FL, 33155, USA

    Kamlesh Kukreja

  2. Health Outcomes, Policy and Economics (HOPE) Center, Department of Radiology, Miami Children’s Hospital, 3100 SW 62nd Ave, Miami, FL, 33155, USA

    L. Santiago Medina

  3. Department of Neurological Surgery, Miami Children’s Hospital and University of Miami, Miami, FL, USA

    Glen Manzano & John Ragheb

Authors
  1. Kamlesh Kukreja
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  2. Glen Manzano
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  3. John Ragheb
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  4. L. Santiago Medina
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Correspondence to Kamlesh Kukreja.

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Kukreja, K., Manzano, G., Ragheb, J. et al. Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful?. Pediatr Radiol 37, 556–560 (2007). https://doi.org/10.1007/s00247-007-0463-8

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  • DOI: https://doi.org/10.1007/s00247-007-0463-8

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