MR imaging of Tornwaldt's cysts

Area of Science:

• Neuroradiology
• Head and Neck Imaging
• Cystic Lesions

Background:

• Tornwaldt's cysts are rare findings in the nasopharynx.
• Their imaging characteristics on routine MRI studies are not well-established.

Purpose of the Study:

• To characterize Tornwaldt's cysts using routine magnetic resonance (MR) imaging.
• To determine the prevalence of Tornwaldt's cysts in a general patient population.

Main Methods:

• Retrospective review of 1208 brain MR studies.
• Assessment of cyst signal intensity, shape, and size.
• Clinical correlation with symptoms and adenoidectomy history.

Main Results:

• Tornwaldt's cysts identified in 1.9% of subjects (23/1208).
• Cysts were isointense to CSF on T2, hyperintense to gray matter on FLAIR, and hyperintense to muscle on T1.
• Mean cyst size was 6.0 mm (major axis) and 5.5 mm (minor axis).
• Two patients reported nasal discharge and headaches; one reported headaches only.

Conclusions:

• Tornwaldt's cysts are identifiable on routine brain MR imaging.
• Characteristic signal intensities on T1, T2, and FLAIR sequences aid diagnosis.
• Prevalence in this cohort was 1.9%.