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Magnetic resonance cisternography for preoperative evaluation of arachnoid cysts

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

With a high likelihood of clinical improvement and low rates of complications, minimally invasive neuroendoscopic surgery is becoming the treatment of choice for symptomatic or growing arachnoid cysts. In neuroendoscopic surgery, visualization of anatomical landmarks is essential in achieving successful fenestration without complications. Because of the restricted visual field in neuroendoscopic surgery, preoperative anatomical assessment is very helpful. Magnetic resonance cisternography (MRC) with high spatial resolution and contrast, using for example 3-D Fourier transformation constructive interference in steady state (CISS) or fast imaging employing steady-state acquisition (FIESTA) sequences, is able to detect the arachnoid cyst wall and neighboring anatomical structures as the anatomical landmarks. We retrospectively reviewed T2-weighted (T2-W) fast spin-echo images, and the MRC and intraoperative findings.

Methods

Axial and coronal T2-W images (6 and 3 mm thickness, respectively) and axial and coronal 0.8 mm thick MRC images with CISS or FIESTA were obtained from four patients with arachnoid cysts treated by neuroendoscopic surgery. Intraoperative findings were reviewed on videotape recorded during the procedures.

Results

At the brain surface, the arachnoid cyst wall could be detected clearly in any of the four patients on MRC images, and was only partly seen in the fourth patient T2-W images. Adjacent important anatomical structures including vessels and cranial nerves, and an enough space for cystocisternostomy were identified on MRC images, and the findings were consistent with the findings during neuroendoscopic surgery.

Conclusion

Preoperative identification of the arachnoid cyst wall and surrounding anatomical structures by MRC may help avoid complications and allow safer neuroendoscopic surgery.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Niigata University, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan

    M. Awaji

  2. Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan

    K. Okamoto

  3. Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan

    K. Nishiyama

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  1. M. Awaji
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  2. K. Okamoto
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  3. K. Nishiyama
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Correspondence to M. Awaji.

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Awaji, M., Okamoto, K. & Nishiyama, K. Magnetic resonance cisternography for preoperative evaluation of arachnoid cysts. Neuroradiology 49, 721–726 (2007). https://doi.org/10.1007/s00234-007-0248-7

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