DWI Findings in a Iatrogenic Lumbar Epidermoid Cyst

Manzo, Gaetana; Gennaro, Angela De; Cozzolino, Andrea; Martinelli, Erika; Manto, Andrea

doi:10.1177/197140091302600412

Cited by 17 publications

(19 citation statements)

References 15 publications

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“…Table 2 summarizes the imaging findings of spinal epidermoids [ 17 , 29 , 32 , 33 ]. Since cerebrospinal fluid (CSF) appears hypointense on T1 and hyperintense on T2, multiple studies proposed using diffusion weighted imaging (DWI) as the most definitive MRI sequence to diagnose and monitor spinal epidermoid tumors [ 17 , 33 ]. On DWI, spinal epidermoid tumors appear hyperintense, which helps differentiate it from CSF, which is hypointense [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Spinal Epidermoid Tumors: Case Report and Review of the Literature

et al. 2018

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Spinal epidermoid tumors are rare, benign tumors that are either acquired from trauma, surgery, or lumbar puncture or arise as congenital lesions, particularly spinal dysraphisms. We report a case of a massive spinal epidermoid tumor and review the literature with a focus on the surgical outcomes. A 71-year-old female patient presented after a fall with subsequent symptoms of severe back and hip pain, as well as loss of motor strength in the left leg. Her magnetic resonance imaging demonstrated a T2/short tau inversion recovery hyperintense mass extending from the level of the T10–11 disc caudally through S2. A biopsy was recommended to determine whether the tumor was radio- or chemo-sensitive. The patient underwent a L4 laminectomy and a pearly-white tumor was encountered, with a subsequent biopsy confirming it to be an epidermoid tumor. The following conclusions can be drawn from a review of the literature. Spinal epidermoid tumors are more common in women and tend to present in younger patients (median age of 23). The majority of patients had acquired lesions (46%). In terms of surgical outcomes for adherent tumors, gross total resection was found to provide optimal outcomes, with 90% of patients improving clinically after surgery.

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Section: Discussionmentioning

confidence: 99%

Spinal Epidermoid Tumors: Case Report and Review of the Literature

et al. 2018

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“…In the cervical region, the fractional anisotropy value is significantly different at the vertebral body level, although there is reportedly no significant difference in the ADC values [17,18]. However, it is difficult to obtain high-resolution images in the spinal region relative to the central nervous region [19], although it is possible to obtain highresolution spinal images by reducing the FOV [20][21][22]. Thus, diffusion tensor tractography and ADC maps are expected to provide high-resolution data for the lumbar region; this can improve the accuracy of the diagnosis of stenosis [9].…”

Section: Discussionmentioning

confidence: 99%

Evaluating Spinal Canal Lesions Using Apparent Diffusion Coefficient Maps with Diffusion-Weighted Imaging

et al. 2020

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Study Design: Observational study.Purpose: To evaluate healthy volunteers and patients with spinal canal lesions using apparent diffusion coefficient (ADC) maps with diffusion-weighted imaging.Overview of Literature: Decompression surgery for lumbar spinal stenosis (LSS) is selected on the basis of subjective assessment and cross-sectional magnetic resonance imaging (MRI). However, there is no objective standard for this procedure.Methods: We performed 3T MRI in 10 healthy volunteers and 13 patients with LSS. The ADC values in the spinal canal were evaluated at 46 vertebrae (L4/5 and L5/S1 for each participant), and the reduced and conventional fields of view were compared.Results: The ADC values were 2.72±0.12 at L4/5 in healthy volunteers, 2.76±0.19 at L5/S1 in healthy volunteers, 1.77±0.58 at L4/5 in patients with LSS, and 2.35±0.29 at L5/S1 in patients with LSS. The ADC value at L4/5 in patients with LSS was significantly lower than that at L5/S1 in patients with LSS and that at L4/5 and L5/S1 in healthy volunteers (<i>p</i> <0.05). With an ADC cutoff value of 2.46 to identify LSS, this approach provided an area under the curve of 0.81, sensitivity of 0.92, and specificity of 0.76 (<i>p</i> <0.05).Conclusions: Preoperative examination using ADC maps permits visualization and quantification of spinal canal lesions, thus proving the utility of ADC maps in the selection of decompression surgery for LSS.

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“…17 High signal on DWI is helpful for differentiating from other cystic diseases. 18 (iii) Spinal mature cystic teratomas are more common in children and adolescents and have no special imaging characteristics, thus the final diagnosis depends on the pathological examination.…”

Section: Discussionmentioning

confidence: 99%

Intraspinal bronchogenic cyst: Series of case reports and literature review

Niu

et al. 2017

The Journal of Spinal Cord Medicine

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Purpose: Spinal bronchogenic cysts (SBCs) are rare congenital lesions. The clinical and imaging characteristics and treatment of SBCs are not well known. We studied three cases of SBCs retrospectively, which were registered in our department and analyzed eight case reports which were all published in English, focusing on providing a deeper knowledge of SBCs. Methods: Three patients with SBCs registered in our department were retrospectively reviewed. Eight reported SBCs cases published from 1992 to 2015 were enrolled in our study. Imaging diagnosis was confirmed by computed tomography (CT), MRI, and computed tomography angiography (CTA). All of our patients and reviewed cases had undergone surgical resection and the final diagnosis was made by pathological examination. Results: Five lesions were located at the cervical spinal canal. Most patients presented with pain in the limbs and back, which might be related to compression of the spinal cord and the reduced blood supply of the anterior spinal artery. The signal intensity on MRI was correlated with cystic fluid traits to a large extent. Seven lesions were partially removed because of the adhesions to the nearby spinal cord. All reported cases had no recurrence in the later follow-up. Conclusions: SBCs can occur anywhere in the spinal canal, but they are more likely to present at the cervical canal and might be present along with some developmental malformations of the spine. We emphasize the role of CT and MRI findings in the disease diagnosis. It is recommended that the lesion should be removed as completely as possible.

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DWI Findings in a Iatrogenic Lumbar Epidermoid Cyst

Cited by 17 publications

References 15 publications

Spinal Epidermoid Tumors: Case Report and Review of the Literature

Spinal Epidermoid Tumors: Case Report and Review of the Literature

Evaluating Spinal Canal Lesions Using Apparent Diffusion Coefficient Maps with Diffusion-Weighted Imaging

Intraspinal bronchogenic cyst: Series of case reports and literature review

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