Rathke's cleft cyst: clinicopathological and MRI findings in 22 patients

Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI

“…11 In addition, RCCs may show patchy or ring enhancement, which can be attributed to inflammation and/or squamous metaplasia in the cyst wall. 15 The presence of an intracystic nodule has been suggested as a characteristic MR imaging feature of RCCs, with an incidence of 37.5%-45%. 9,13 Although intracystic nodules were more common in RCCs than in cystic pituitary adenomas, we also observed intracystic nodules in pituitary adenomas (67.9% vs 16.7%, respectively).…”

“…RCCs are sometimes indistinguishable from cystic pituitary adenomas on MR imaging, and a previous study reported that 50% of surgically proven RCCs were misdiagnosed as pituitary adenomas preoperatively because of their various signal intensities, which ranged from hypointense to hyperintense on both T1-and T2-weighted images. 15 These various MR signal intensities depend on the composition of the cyst, including protein, mucopolysaccharides, and cholesterol. 15,28 Another study reported that wall enhancement of cystic lesions may play a role in differentiating neoplastic from nonneoplastic cysts.…”

“…15 These various MR signal intensities depend on the composition of the cyst, including protein, mucopolysaccharides, and cholesterol. 15,28 Another study reported that wall enhancement of cystic lesions may play a role in differentiating neoplastic from nonneoplastic cysts. 29 However, RCCs are often surrounded by the enhancing normal pituitary gland, thus mimicking wall enhancement, especially when there is a partial volume-averaging effect.…”

“…[9][10][11][12] Depending on its cystic content and the presence of an associated intracystic nodule, an RCC may show various signal intensities on both T1-and T2-weighted images. [13][14][15] More specifically, T1 hyperintensity and T2 hypointensity of an RCC associated with a high intracystic protein content can mimic cystic pituitary adenoma with hemorrhage, which makes imaging diagnosis of a cystic pituitary adenoma or an RCC a challenge. Preoperative differentiation between a cystic pituitary adenoma and an RCC is important for treatment planning.…”

A New Perspective About Diagnosing Rathke’s Cleft Cyst: Localization of the Cyst in Reference to the Pituitary Gland

“…However, these features were not effective for differential diagnosis. MRI signal intensity depends on the composition of the cyst, which may include protein, mucopolysaccharides, and cholesterol (23,24). Hence intensity is insufficient for making the diagnosis.…”