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Multiple occipital defects caused by arachnoid granulations: Emphasis on T2 mapping
Chao-Xuan Lu1, Yong Du, Xiao-Xue Xu
1Chao-Xuan Lu, Yong Du, Xiao-Xue Xu, Yang Li, Han-Feng Yang, Shao-Qiang Deng, Dong-Mei Xiao, Bing Li, Yun-Hong Tian, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
World Journal of Radiology
|August 18, 2012
Summary
Multiple arachnoid granulations (AGs) can mimic bone lesions like multiple myeloma on CT scans. Advanced MRI techniques, including T2 mapping, help differentiate these benign AGs from other pathologies.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Headache can be a symptom of various neurological conditions.
- Osteolytic lesions on CT scans require careful differential diagnosis.
- Arachnoid granulations are common, benign lesions often found incidentally.
Purpose of the Study:
- To describe the imaging characteristics of multiple arachnoid granulations presenting as occipital osteolytic lesions.
- To differentiate multiple arachnoid granulations from neoplastic or other bone-destructive processes using CT and MRI.
- To highlight the utility of T2 mapping in the diagnosis of arachnoid granulations.
Main Methods:
- Computed tomography (CT) for initial lesion detection.
- Magnetic resonance imaging (MRI) including conventional sequences and T2 mapping.
- Single photon emission computed tomography (SPECT) with (99m)Tc-Methyl diphosphonate.
Main Results:
- CT revealed multiple occipital osteolytic lesions suspicious for myeloma.
- MRI showed lesions with cerebrospinal fluid (CSF)-like signal intensity, no diffusion restriction, and intrinsic enhancement.
- T2 mapping demonstrated T2 relaxation times similar to CSF.
- SPECT showed no increased radiotracer uptake.
- Lesions were diagnosed as multiple arachnoid granulations (AGs).
Conclusions:
- Multiple arachnoid granulations can present as osteolytic lesions on CT, mimicking other pathologies.
- MRI, particularly with T2 mapping, is crucial for accurate differentiation.
- T2 mapping showing CSF-like signal intensity is a key finding for diagnosing AGs.
