Saturday 19 November 2011

Ependymal cyst MRI

A 50 yo male c/o giddiness.

MRI Brain shows:
An intra ventricular cyst in body of right lateral ventricle.
Iso intense to csf, complete signal suppression on Flair.
No restricted diffusion on dw images.
Thin imperceptible wall, no significant mass effect except mild bulge on wall of right lateral ventricle. No obvious ventricular trapping.
Cyst is very close to the right side choroid plexus and seen separate from choroid plexus.

Imagingwise : Ependymal cyst.


Syn: Neuroepithelial cyst.
A congenital benign ependymal lined cyst.
Most common location is intra ventricular, typically lateral ventricle.
Non enhancing cyst with thin imperceptible wall, same density on CT / signal intensity on MRI as that of Csf.
Calcification is extremely rare.

Differential diagnosis:
Choroid plexus cyst – usually bilateral, restricted diffusion is typical.
Arachnoid cyst – intra ventricular location is uncommon, and then may become indistinguishable, iso intense to csf too.

Typically asymptomatic.
Noted as an incidental finding and clinically insignificant in pt scanned for headache and seizures.
May cause obstruction to csf flow and become clinically significant.

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