Neuroenteric cysts of the brain-comprehensive magnetic resonance imaging

Divyata R Hingwala; Neelima Radhakrishnan; Chandrasekharan Kesavadas; Bejoy Thomas; Tirur Raman Kapilamoorthy; Vishnupuri V Radhakrishnan

doi:10.4103/0971-3026.116579

Indian Journal of Radiology and Imaging, Table of Contents

CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(02): 155-163
DOI: 10.4103/0971-3026.116579

ORIGINAL ARTICLE

Neuroenteric cysts of the brain-comprehensive magnetic resonance imaging

Authors

Divyata R Hingwala

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
Neelima Radhakrishnan

Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
Chandrasekharan Kesavadas

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
Bejoy Thomas

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
Tirur Raman Kapilamoorthy

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
Vishnupuri V Radhakrishnan

Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala

Abstract

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Abstract

Neuroenteric cysts are developmental cysts that should be differentiated from other, more common non-neoplastic cysts as well as cystic neoplasms. While these lesions may have varied imaging findings, T1 hyperintense prepontine lesion due to mucinous/proteinaceous content is characteristic. Location and imaging characteristics aid in formulating the correct diagnosis of neuroepithelial/neuroenteric cysts. Magnetic resonance spectroscopy (MRS) has the specific finding of N-Acetyl Aspartate (NAA)-like peak at 2.02 ppm which is not seen in other cystic lesions. In this study, we aim to discuss the imaging findings of these lesions on conventional and advanced MRI findings and provide radiologic-pathologic correlation. We also briefly describe the pathogenesis, embryology and radiological differential diagnoses of these cysts.

Keywords

Diffusion tensor imaging - magnetic resonance imaging - magnetic resonance spectroscopy - neuroenteric cyst - neuroepithelial cyst

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References

References
1 Cheng JS, Cusick JF, Ho KC, Ulmer JL. Lateral supratentorial endodermal cyst: Case report and review of literature. Neurosurgery 2002;51:493-9.
2 Savage JJ, Casey JN, McNeill IT, Sherman JH. Neurenteric cysts of the spine. J Craniovertebr Junction Spine 2010;1:58-63.
3 Inoue T, Kawahara N, Shibahara J, Masumoto T, Usami K, Kirino T. Extradural neurenteric cyst of the cerebellopontine angle: Case report. J Neurosurg 2004;100:1091-3.
4 Gao P, Osborn AG, Smirniotopoulos JG. Neurenteric cysts: Pathology, imaging spectrum, and differential diagnosis. Int J Neuroradiol 1995;1:17.
5 Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG Intracranial Neurenteric cysts: Imaging and pathology spectrum. AJNR Am J Neuroradiol 2006;27:1211-6.
6 Tan GS, Hortobagyi T, Al-Sarraj S, Connor SE. Intracranial laterally based supratentorial neurenteric cyst. Br J Radiol 2004;77: 963-5.
7 Ormond DR, Omeis I, Mohan A, Murali R, Narayan P. Obstructive hydrocephalus due to a third ventricular neuroepithelial cyst. J Neurosurg Pediatr 2008;1:481-4.
8 Nakase H, Ishida Y, Tada T, Sakaki T, Goda K, Tunoda S, et al. Neuroepithelial cyst of the lateral ventricle: Clinical features and treatment. Surg Neurol 1992;37:94-100.
9 Czervionke LF, Daniels DL, Meyer GA, Pojunas KW, Williams AL, Haughton VM. Neuroepithelial cysts of the lateral ventricles: MR appearance. AJNR Am J Neuroradiol 1987;8:609-13.
10 Shakudo M, Inoue Y, Ohata K, Tanaka S. Neurenteric cyst with alteration of signal intensity on follow-up MR images. AJNR Am J Neuroradiol 2001;22:496-8.
11 Tillich M, Ranner G, Trummer M, Kleinert R. Symptomatic neuroepithelial (ependymal) cyst of the fourth ventricle: MR appearance. AJR Am J Roentgenol 1999;172:553-4.
12 Numaguchi Y, Foster RW, Gum GK. Large asymptomatic noncolloid neuroepithelial cysts in the lateral ventricle: CT and MR features. Neuroradiology 1989;31:98-101.
13 Periakaruppan A, Kesavadas C, Radhakrishnan VV, Thomas B, Rao RM. Unique MR spectroscopic finding in colloid-like cyst. Neuroradiology 2008;50:137-44.
14 Majós C, Aguilera C, Cos M, Camins A, Candiota AP, Delgado-Goñi T, et al. In vivo proton magnetic resonance spectroscopy of intraventricular tumours of the brain. Eur Radiol 2009;19:2049-59.
15 Candiota AP, Majós C, Bassols A, Cabanas ME, Acebes JJ, Quintero MR, et al. Assignment of the 2.03 ppm resonance in in vivo 1H MRS of human brain tumour cystic fluid: Contribution of macromolecules. MAGMA 2004;17:36-46
16 Lantos PL, Louis DN, Rosenblum MK, Kleihues P. Tumours of the nervous system. In: Graham DI, Lantos PL, editors. Greenfield′s Neuropathology. 7^th ed., vol. 2. London: Arnold Publisher; 2002. p. 968-9.