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Published on: November 20, 2015
[MRI in the diagnosis of Rathke's cleft cyst]
N Mnif1, A Hamrouni, C Iffenecker
1Service de radiologie, Hôpital Charles Nicolle, Tunis, Tunisie. najla.mnif@ms.tn
Purpose:
Rathke's cleft cysts are non neoplastic lesions of the sellar area that seldom are symptomatic. Their incidence has been underestimated before magnetic resonance imaging (MRI). The aim of this work was to assess the value of MRI in the diagnosis and differential diagnosis of Rathke's cleft cyst based on a retrospective review of 12 cases and a review of the literature.
Patients And Methods:
We retrospectively reviewed the MRI features of 12 patients with Rathke's cleft cyst collected over 4.5 years. Patients included ten females and two males (mean age: 39 years). The most common presentation was the association of dysmenorrhea and pituitary dysfunction. MRI examinations were performed using a 1.5 Tesla system, T1 and T2 weighted sequences performed before and after Gd- DTPA injection. Signal intensity, shape, size and location of the lesion were analyzed.
Results:
In all cases, MRI examination showed a cystic lesion of variable size and signal intensity. The cyst was purely intrasellar in nine cases and a suprasellar extension was noted in three cases. Five patients underwent surgery providing pathological confirmation, four underwent routine follow-up and three were lost of follow-up.
Conclusion:
We conclude that MRI is an efficient tool for diagnosis, allowing appropriate medical decision making.
Insights
Magnetic resonance imaging (MRI) is valuable for diagnosing Rathke's cleft cysts, non-neoplastic sellar lesions. This study confirms MRI's efficiency in identifying these cysts, aiding medical decisions.
Area of Science:
- Neuroradiology
- Endocrinology
- Sellar Region Pathology
Context:
- Rathke's cleft cysts are typically asymptomatic sellar lesions.
- Their incidence is increasingly recognized with advancements in MRI technology.
Purpose:
- To evaluate the diagnostic and differential diagnostic utility of MRI for Rathke's cleft cysts.
- To correlate MRI findings with clinical presentations and pathological confirmation.
Summary:
- A retrospective review of 12 Rathke's cleft cyst cases analyzed MRI features (signal intensity, shape, size, location) using T1 and T2 weighted sequences.
- All cases demonstrated cystic lesions, with variations in size and signal intensity. Nine were intrasellar, and three had suprasellar extension.
- Five patients had surgical confirmation; others had follow-up or were lost to follow-up.
Impact:
- MRI is an effective tool for diagnosing Rathke's cleft cysts.
- Accurate MRI diagnosis facilitates appropriate medical management and decision-making for sellar region lesions.
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