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The radiology of sacral cysts
R A Willinsky1, H Grosman, P W Cooper
1Department of Radiological Sciences, University of Toronto, Ontario.
Summary
Sacral cysts, fluid-filled lesions in the sacrum, can be asymptomatic or symptomatic. Computed tomography (CT) reveals a characteristic appearance, aiding diagnosis in patients with spinal abnormalities.
Area of Science:
- Radiology
- Neurosurgery
- Spinal Imaging
Background:
- Sacral cysts are rare lesions that can present with varied clinical and radiological findings.
- Diagnosis can be challenging, often requiring advanced imaging techniques.
Purpose of the Study:
- To review and classify the radiological findings of sacral cysts.
- To identify characteristic imaging features that aid in diagnosis.
Main Methods:
- Retrospective review of radiological findings in 10 patients with sacral cysts.
- Analysis of plain films, computed tomography (CT), myelography, and magnetic resonance imaging (MRI).
Main Results:
- Cysts were incidental findings in 4 patients and suggested by plain films in 3.
- CT demonstrated a homogeneous mass (5-20 Hounsfield units) causing sacral foramina or canal expansion in 8 patients.
- MRI confirmed a fluid-filled lesion in one patient; myelography was non-diagnostic in 3/5 cases.
Conclusions:
- Sacral cysts can be asymptomatic or symptomatic and may or may not communicate with the subarachnoid space.
- Characteristic CT findings, including expansion of sacral foramina/canal by a low-density mass, are indicative of sacral cysts.
- Advanced imaging like MRI can confirm the fluid-filled nature of these lesions.