Rathke’s cleft cysts: differentiation from other cystic lesions in the pituitary fossa by use of single-shot fast spin-echo diffusion-weighted MR imaging

Kunii, Norihiko; Abe, Takumi; Kawamo, Michiari; Tanioka, Daisuke; Izumiyama, Hitoshi; Moritani, Toshio

doi:10.1007/s00701-007-1234-x

Cited by 68 publications

(37 citation statements)

References 21 publications

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“…A pseudo-fluid-fluid level may be observed in craniopharyngiomas, corresponding to tenacious secretions or the position of the interface between the fluid and solid components of the tumor (26). Furthermore, diffusion-weighted MRI and relative apparent diffusion coefficient, as well as clinical presentation and endocrine appearance, have been suggested to be beneficial in differentiating among pituitary adenomas, RCCs, craniopharyngiomas and other cystic sellar lesions (28).…”

Section: Discussionmentioning

confidence: 99%

Fluid-fluid level on magnetic resonance images may predict the occurrence of pituitary adenomas in cystic sellar-suprasellar masses

Xiao

Wang

Zhang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to evaluate the value of identifying fluid-fluid level via preoperative magnetic resonance (MR) images in differentiating pituitary adenomas from craniopharyngioma, Rathke's cleft cyst (RCC), and other cystic sellar-suprasellar lesions. The data of 293 consecutive patients who underwent surgery for sellar-suprasellar lesions between July 2010 and December 2012 was retrospectively reviewed, and a total of 133 cystic cases were included in the present study. MR images and pathological features of all subjects were examined. Among the 133 cystic sellar-suprasellar masses, there were 78 cases of pituitary adenomas, 31 cases of craniopharyngioma, 21 cases of RCC, one case of epidermoid cyst and two cases of abscess. Fluid-fluid levels were identified n 43 cases (55.13%) of cystic pituitary adenomas, with a single fluid level in 23 cases, two fluid levels in 8 cases, and three levels or more in 12 cases. Two cases (6.45%) of craniopharyngioma, and one case (4.76%) of RCC presented single fluid level. No instances of fluid-fluid levels were observed in epidermoid cyst or abscess. Fluid-fluid levels were typically exhibited on axial T2-weighted images. The identification of fluid-fluid level in cysts provides useful diagnostic value in distinguishing pituitary adenoma from other sellar-suprasellar lesions. The findings of the present study suggest that a sellar-suprasellar mass with a fluid-fluid level inside the tumor is most likely a pituitary adenoma, particularly if multiple fluid levels are observed in the same tumor. The fluid-fluid level is typically clearly depicted on axial or sagittal MR images, suggesting subacute or chronic hemorrhage in pituitary adenomas.

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Section: Discussionmentioning

confidence: 99%

Fluid-fluid level on magnetic resonance images may predict the occurrence of pituitary adenomas in cystic sellar-suprasellar masses

Xiao

Wang

Zhang

et al. 2017

Experimental and Therapeutic Medicine

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“…[1][2][3][4][5][6][7][8][9][10] However, it is difficult to evaluate skull base structures by the most common imaging technique used with echo-planar (EP)-DWI. Previous studies have revealed the efficacy of DWI for skull base tumors such as pituitary adenoma; however, they are mostly limited to macroadenomas large enough to calculate the ADC by using EP sequences.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, previous studies by using EP-DWI were mainly limited to pituitary macroadenoma, apoplexy, abscess, or other parasellar lesions. [3][4][5][6][7] Other researchers applied non-EP-DWI such as single-shot fast spinecho, 8 line scan, 9 and periodically rotated overlapping parallel lines with enhanced reconstruction 10 DWI for sellar and parasellar lesions to overcome image degradation. In the present study, we used DSDE-TFE, which enabled us to obtain a 3D dataset and high spatial resolution (1.5 ϫ 1.5 ϫ 1.5 mm 3 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Diffusivity in the Anterior Lobe of the Pituitary Gland: 3D Turbo Field Echo with Diffusion-Sensitized Driven-Equilibrium Preparation

Hiwatashi¹,

Yamada²,

Togao

et al. 2013

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: 3D turbo field echo with diffusion-sensitized driven-equilibrium preparation is a non-echo-planar technique for DWI, which enables high-resolution DWI without field inhomogeneity-related image distortion. The purpose of this study was to evaluate the feasibility of diffusion-sensitized driven-equilibrium turbo field echo in evaluating diffusivity in the normal pituitary gland.

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“…Conversely, a radiological diagnosis of CP was supported by features such as superior tumor lobulation, larger tumor volume, compression of the third ventricle, and a reticular enhancement pattern of the solid tumor portion. Kunii et al 57 used single-shot fast spin echo diffusion weighted MR imaging to differentiate cystic sellar and suprasellar lesions. They reported that RCCs could be identified using this imaging modality because of the lesion's increased regional apparent diffusion coefficient values, in contrast with those of CPs and hemorrhagic pituitary adenomas.…”

Section: Imaging Featuresmentioning

confidence: 99%

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Zada¹,

Lin²,

Ojerholm³

et al. 2010

FOC

229

182

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Object Cystic epithelial masses of the sellar and parasellar region may be difficult to differentiate on a clinical, imaging, or even histopathological basis. The authors review the developmental relationships and differentiating features of various epithelial lesions of the sellar region. Methods The authors performed a review of the literature to identify previous studies describing the etiological relationships and differentiating features of various cystic sellar lesions, including craniopharyngioma (CP), Rathke cleft cyst, xanthogranuloma, and dermoid and epidermoid cysts. Results There is significant evidence in the literature to support a common ectodermal origin of selected sellar and suprasellar cystic lesions, which may account for the overlap of features and transitional states observed in some cases. Research obtained from animal studies and reports of transitional cystic epithelial masses or lesions crossing over from typical to more aggressive pathological subtypes have collectively provided a solid foundation for this theory. Histological features that signify transitional entities beyond simple benign Rathke cleft cysts include squamous metaplasia, stratified squamous epithelium, and ciliated or mucinous goblet cells in squamous-papillary CPs. Several studies have identified key clinical, imaging, and histopathological features that can be used in the differentiation of these lesions. Conclusions The pattern of embryological formation of the hypothalamic-pituitary axis plays a major role in its propensity for developing cystic epithelial lesions. Subsequent inflammatory, metaplastic, and neoplastic processes may promote further progression along the pathological continuum, ranging from benign epithelial cysts to aggressive neoplastic cystic CPs. Selected clinical, imaging, and histopathological features can be used collectively to help differentiate these lesions and assign a formal diagnosis, thus accurately guiding further treatment.

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Rathke’s cleft cysts: differentiation from other cystic lesions in the pituitary fossa by use of single-shot fast spin-echo diffusion-weighted MR imaging

Cited by 68 publications

References 21 publications

Fluid-fluid level on magnetic resonance images may predict the occurrence of pituitary adenomas in cystic sellar-suprasellar masses

Fluid-fluid level on magnetic resonance images may predict the occurrence of pituitary adenomas in cystic sellar-suprasellar masses

Evaluation of Diffusivity in the Anterior Lobe of the Pituitary Gland: 3D Turbo Field Echo with Diffusion-Sensitized Driven-Equilibrium Preparation

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

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