Intracranial epidermoid cysts: diffusion-weighted, FLAIR and conventional MR findings

Hakyemez, Bahattin; Aksoy, Ümit; Yıldız, Hicran; Ergin, Necdet

doi:10.1016/j.ejrad.2004.06.018

Cited by 93 publications

(62 citation statements)

References 17 publications

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“…epidermoid is thought to be the cause for high signal intensity on diffusion-weighted sequences (17). However, recent reports have showed this to be due to the T2 shinethrough effect rather than restricted diffusion and in these studies eADC was used to demonstrate this effect (21,22). High FA observed in our study suggests that the diffusion is anisotropic; further, the elevated CP and low value of CL indicates that the diffusion is restricted to the plane rather than in a single direction as in the case of white matter.…”

Section: Discussionmentioning

confidence: 99%

Diffusion tensor and tensor metrics imaging in intracranial epidermoid cysts

Kannath

Radhakrishnan

Saini

et al. 2009

Magnetic Resonance Imaging

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Purpose:To explore the utility of diffusion tensor imaging (DTI) and diffusion tensor metrics (DTM) in characterizing the structural pathology of epidermoid cysts. DTI gives information about the tissue structure; a high fractional anisotropy (FA) indicates a highly structured orientation of the tissue, fibers, or white matter tracts. Based on the tensor rank, a set of three metrics has been described that can be used to measure the directional dependence of diffusion: linear anisotropy (CL), planar anisotropy (CP), and spherical anisotropy (CS). DTM takes into account the shape of diffusion anisotropy and hence may provide better insight into the orientation of structures than FA.Materials and Methods: DTI was performed in three patients with epidermoid cysts. FA, directionally-averaged mean diffusivity (Dav), exponential apparent diffusion coefficient (eADC), and DTM, such as CL, CP, and CS, were measured from the tumor core as well as from the normalappearing white matter. Histopathological correlation was obtained. Results:Epidermoid cysts showed high FA with Dav values similar to that of normal white matter. eADC maps did not show any restriction of diffusion. FA values were high, but not as high as that for the white matter. CP values were higher and CL values were lower than those obtained for the white matter in various regions. Conclusion:High CP values suggest preferential diffusion of water molecules along a two-dimensional geometry, which could be attributed to the well-structured orientation of keratin filaments and flakes within the tumor as demonstrated by histopathology. Advanced imaging modalities like DTI with DTM can provide information regarding the microstructural anatomy of the epidermoid cysts.

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Section: Discussionmentioning

confidence: 99%

Diffusion tensor and tensor metrics imaging in intracranial epidermoid cysts

Kannath

Radhakrishnan

Saini

et al. 2009

Magnetic Resonance Imaging

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“…2 They are intra dural and can be found anywhere in the cranial cavity including vault .Majority of the times they are located in C-P angle about 60%, followed by 4 th ventricle and suprasellar regions. [3][4][5] They have an irregular cauliflower like outer surface 5 and contain pearly white keratin material laden with cholesterol crystals hence the name pearl tumour. They are commonly found at the bases and tend to grow into the available cisternal spaces encasing all the neurovascular structures in doing so, and are tightly adherent to underlying structures at some places posing great difficulty in excising them.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical excision of intracranial epidermoids: a short surgical series of 12 cases

et al. 2015

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“…The exact cause for the diffusion-weighted hyperintensity, however, is disputed. Some authors suggest that the hyperintensity represents T 2 shine-through only [32], whereas others suggest that the keratinaceous material within the epidermoid cyst restricts diffusion [33].…”

Section: Developmental/congenital Epidermoid Cystmentioning

confidence: 99%

“…Epidermoid cysts are uncommon developmental/congenital lesions that account for 0.2-1.8% of intracranial neoplasms [32]. The two most common locations for epidermoid cysts are the cerebellopontine angle (40-60%) and fourth ventricle (5-18%) [32].…”

Section: Developmental/congenital Epidermoid Cystmentioning

confidence: 99%

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“Dazed and diffused”: making sense of diffusion abnormalities in neurologic pathologies

O’Connor

Barest²,

Moritani³

et al. 2013

BJR

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To review diffusion abnormalities seen in diffusion-weighted MRI in neurological pathologies. We examine the clinical significance of the abnormalities in a broad spectrum of neurological diseases and highlight our current understanding of their causes. Diffusion abnormalities seen on diffusion-weighted MRI can play an important role in the diagnosis and follow-up of a broad spectrum of neurological diseases. A thorough understanding of the appearance and significance of these abnormalities is critical in patient management.Although the best known use of diffusion-weighted imaging (DWI) in MRI of the brain is detection of acute vaso-occlusive infarct, diffusion abnormalities occur in a wide spectrum of neurological pathologies. These diffusion abnormalities provide information that can directly affect the management of a patient, whether identifying pathology that would otherwise go unrecognised, narrowing a broad differential diagnosis, identifying conditions that require emergent intervention, evaluating response to treatment or providing prognostic information about a patient's expected clinical course. In this review, we explain the significance of diffusion abnormalities in a variety of neurological diseases and highlight our current understanding of the causes of these diffusion abnormalities.

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Intracranial epidermoid cysts: diffusion-weighted, FLAIR and conventional MR findings

Cited by 93 publications

References 17 publications

Diffusion tensor and tensor metrics imaging in intracranial epidermoid cysts

Diffusion tensor and tensor metrics imaging in intracranial epidermoid cysts

Microsurgical excision of intracranial epidermoids: a short surgical series of 12 cases

“Dazed and diffused”: making sense of diffusion abnormalities in neurologic pathologies

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