[CSF connection of the intracranial cysts and cyst like lesions: Analysis with flow sensitive phase-contrast Cine MR imaging].

PURPOSE: To evaluate the potential role of ECG-gated flow sensitive phase contrast cine magnetic resonance (MR) imaging in detecting the communication between cystic intracranial lesions and neighboring cerebrospinal fluid (CFS) spaces.

MATERIALS AND

METHODS

Twenty one patients with intracranial cystic lesions (arachnoid cyst, 15; epidermoid cyst, 2; glioma, 1; dermoid cyst, 1; and mega cisterna magna, 2) underwent CSF flow studies in addition to the conventional MR sequences. MR imaging was performed with ECG gated two dimensional fast imaging steady-state precession sequence (2D-FISP). Using the cine images obtained per cardiac cycle, we tried to identify the communication between cysts or cyst-like structures and neighboring CSF spaces. Results were compared with intraoperative findings, computed tomography (CT) cisternography and scintigraphy.

RESULTS

In 14 cystic lesions, no communication was identified. In five arachnoid cysts, a pulsatile CSF flow was seen in the cysts. In the two enlarged cisterna magnas there was a pulsatile flow coming from the central CSF spaces. All intraoperative, CT cisternography and scintigraphy findings were compatible with the results of the MR flow studies.

CONCLUSION

Cine-mode MR imaging with ECG gated 2D phase contrast MR sequence technique is a reliable noninvasive alternative to CT cisternography for functional evaluation of the cystic lesions, because it enables visualization of the flow communication between cysts or cyst-like structures and neighboring CSF spaces.