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Rate of Missed Intracranial Colloid Cysts on MRI and CT
Ayat A Sharif1, Erik DiGiacomo1, Marcin Czarniecki2
1Neuroradiology, Georgetown University School of Medicine, Washington, USA.
Cureus
|December 19, 2023
Summary
Intracranial colloid cysts, though rare, are frequently missed on CT and MRI scans. This study found a 20.1% non-detection rate, highlighting the need for improved diagnostic strategies for these potentially serious brain lesions.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Intracranial colloid cysts of the third ventricle are uncommon but can cause obstructive hydrocephalus.
- These cysts are often asymptomatic but can lead to acute neurological deficits.
- Despite being visible on CT and MRI, colloid cysts are frequently overlooked in diagnostic imaging.
Purpose of the Study:
- To determine the rate at which intracranial colloid cysts are missed on neuroimaging (CT and MRI).
- To assess the diagnostic sensitivity of current imaging practices for third ventricular colloid cysts.
Main Methods:
- A retrospective review of 229 confirmed cases of intracranial colloid cysts was conducted.
- Imaging reports and scans from a Picture Archiving and Communication System (PACS) between 2010 and 2020 were analyzed.
- Two neuroradiologists reviewed prior CT and MRI scans to identify missed diagnoses.
Main Results:
- Out of 229 confirmed cases, 46 (20.1%) had prior imaging that depicted a colloid cyst but was not mentioned in the interpretative report.
- This indicates a significant rate of missed diagnoses for intracranial colloid cysts on routine neuroimaging.
Conclusions:
- Intracranial colloid cysts are missed at a high rate, posing a risk of significant patient morbidity and mortality.
- Proactive searching and development of enhanced detection methods are crucial for improving the diagnosis of these lesions.
- Radiologists should consider colloid cysts in their search patterns, especially when evaluating third ventricular abnormalities.
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