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      Intracranial Cysts: An Imagery Diagnostic Challenge

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      Publication date (Electronic):
      Journal: The Scientific World Journal
      Publisher: Hindawi Publishing Corporation

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          Abstract

          Intracerebral cysts and cystic appearing intracerebral masses are common findings at routine cerebral imaging examination. We discuss here the most interesting aspects of some intracerebral cysts encountered in medical practice in terms of imaging, clinical and pathological description, and problems of differential diagnosis. On an almost routine basis, the neurologists have to deal with such differentials. Therefore, we aim to mention here some of the frequently encountered diagnosis problems when a patient presents with a cystic cerebral mass.

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          Intracranial cysts: radiologic-pathologic correlation and imaging approach.

          Thomas Osborn, M Preece (2006)
          Cysts and cystic-appearing intracranial masses have a broad imaging and pathologic spectra. The authors review the pathologic findings, origin, radiologic appearance, and differential diagnosis of many different intracranial cysts. A diagnostic algorithm based on most common anatomic locations is presented that helps narrow the differential diagnosis.
          Article 0 comments Cited 146 times – based on 0 reviews     Review now
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            Neurocysticercosis: radiologic-pathologic correlation.

            Jose J Higuera, Jesús Casillas-Rodríguez, T Hayama … (2010)
            Neurocysticercosis is a neurologic parasitic disease caused by the encysted larva of the tapeworm Taenia solium and is the most important parasitic disease of the human central nervous system. It is the most common cause of acquired epilepsy in endemic settings and constitutes a public health challenge for most of the developing world. Nowadays, however, as a result of globalization, neurocysticercosis is being seen more frequently in developed countries as well. Neurocysticercosis is acquired through fecal-oral contamination, and the disease course is complex, with two intermediate hosts (ie, pigs and humans) and a definitive host (humans). Traditionally, it has been classified into active and nonactive forms according to disease location. Radiologists must be aware of its imaging appearance, which is quite variable, as is the differential diagnosis. Imaging findings depend on several factors, including the stage of the life cycle of T solium at presentation; the number and location (ie, subarachnoid, cisternal, or intraventricular) of parasites; and associated complications such as vascular involvement (ie, arteritis with or without infarction), inflammatory response (ie, edema, gliosis, or arachnoiditis), and, in ventricular forms, degree of obstruction. Thus, the diagnostic approach, management, and prognosis for neurocysticercosis differ widely depending on the type of infection. © RSNA, 2010.
            Article 0 comments Cited 40 times – based on 0 reviews     Review now
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              Pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions: differentiation using MRI.

              Jennifer Choi, Jaeuk Kim, Thomas Chang … (2007)
              To determine the differential magnetic resonance imaging (MRI) features of pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions. The MRI images of 64 patients with pituitary adenoma (n=38), craniopharyngioma (n=13), or Rathke cleft cyst (n=13) were retrospectively reviewed by three neuroradiologists. The following characteristics were evaluated: shape, volume, extent, component characteristics, signal intensities of solid portions on T2-weighted images, signal intensities of cystic portions on T1-weighted images, and enhancement patterns of solid portions and cyst walls of tumours. Fisher's exact test applied with Bonferroni correction was used for multiple comparison. A flowchart for differential diagnosis was constructed based on statistical analysis of the results. A snowman shape, solid characteristics, and homogeneous enhancement of the solid portion were more common in pituitary adenomas (p<0.017). A superiorly lobulated shape, third ventricle compression by superior tumour extension, mixed solid and cystic characteristics, and reticular enhancement of the solid portion were more common in craniopharyngiomas (p<0.017). Finally, an ovoid shape, a small tumour volume, cystic characteristics, and no or thin cyst wall enhancement were more common in Rathke cleft cysts (p<0.017). The flowchart yielded diagnostic accuracies as follows: 92.1% in pituitary adenoma; 92.3% in craniopharyngioma; 92.3% in Rathke cleft cyst; and 92.2% overall. A combination of MRI findings is helpful in the differential diagnosis of the three tumours involving both intrasellar and suprasellar regions.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ScientificWorldJournal
                Journal ID (iso-abbrev): ScientificWorldJournal
                Journal ID (publisher-id): TSWJ
                Title: The Scientific World Journal
                Publisher: Hindawi Publishing Corporation
                ISSN (Electronic): 1537-744X
                Publication date Collection: 2013
                Publication date (Electronic): 2 May 2013
                Volume: 2013
                Electronic Location Identifier: 172154
                Affiliations
                Department of Neurology, Colentina Clinical Hospital, CDPC, School of Medicine, “Carol Davila” University of Medicine and Pharmacy, 19-21 Şos. Stefan cel Mare, 020125 Bucharest, Romania
                Author notes

                Academic Editors: J. Benito-Leon and W. Hall

                Author information
                https://orcid.org/0000-0003-4826-2598
                Article
                DOI: 10.1155/2013/172154
                PMC ID: 3659469
                PubMed ID: 23737706
                SO-VID: 1e280e83-01b5-4142-a920-3921ad5ca8ac
                Copyright © Copyright © 2013 A. Oprişan and B. O. Popescu.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 24 March 2013
                Date accepted : 13 April 2013
                Categories
                Subject: Review Article

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