Arachnoid cyst MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]

Overview

On brain/spine MRI, arachnoid cysts are characterized by cystic images with similar density to CSF and non-enhancing borders, mostly found in the middle cranial fossa while they only rarely occur in the spinal cord. MRIs are more adequate than CT scans for evaluating arachnoid cysts.

MRI

Differential Diagnosis

Arachnoid cysts differential diagnosis[4]
Intraventricularly: Colloid cysts
Intraparenchymally: Parasitic infections, cystic metastases
Porencephalic cysts
Craniopharyngiomas
Holoprosencephalies
Agenesis of corpus callosum
Defect in the hemispheral cleavage
Dandy-Walker complex (posterior fossa cysts)

As differential diagnosis, the following hypothesis must be considered:

  1. Enlarged CSF space;
  2. Epidermoid cyst;
  3. Subdural hygroma/chronic subdural hemorrhage;
  4. Cystic tumors;
  5. Pilocytic astrocytoma;
  6. Hemangioblastoma;
  7. Neurenteric cyst;
  8. Neuroglial cyst;
  9. Porencephalic cyst;
  10. Neurocysticercosis.[5]

References

  1. Robertson, S. J., S. M. Wolpert, and V. M. Runge. "MR imaging of middle cranial fossa arachnoid cysts: temporal lobe agenesis syndrome revisited." American journal of neuroradiology 10.5 (1989): 1007-1010.
  2. "Arachnoid Cysts - Imaging". Medscape. 06/26/2020. Check date values in: |date= (help)
  3. "Arachnoid Cysts". MedPix. 06/26/2020. Check date values in: |date= (help)
  4. Cincu, Rafael, Amit Agrawal, and Jose Eiras. "Intracranial arachnoid cysts: current concepts and treatment alternatives." Clinical neurology and neurosurgery 109.10 (2007): 837-843.
  5. "Arachnoid Cysts - Radiopaedia". Radiopaedia. 06/26/2020. Check date values in: |date= (help)

MRI Examples of Arachnoid Cysts

(Images courtesy of RadsWiki)

Patient #1: Left middle cranial fossa arachnoid cyst

Patient #2: CT and MR images demonstrate a hemorrhagic arachnoid cyst