Dados do Trabalho

Título

LOOK TO THE BUBBLE: NEURORADIOLOGICAL ASPECTS OF INTRACRANIAL CYSTIC LESIONS

Introdução e objetivo(s)

Intracranial cysts are common findings on brain imaging and can have multiple origins.

Distinguishing between these cysts based solely on imaging findings can be difficult due to their varied presentations.

Accurate diagnosis is essential, as the correct characterization of the cystic formation directly impacts clinical management, guiding decisions between observation, clinical treatment, or surgical intervention.

An anatomical-based classification, combined with relevant clinical data, refines diagnosis by grouping differential diagnoses and narrowing possibilities, facilitating a systematic approach that is particularly helpful for less experienced radiologists.

This work focuses primarily on non-neoplastic primary cysts, excluding neoplasms with cystic components.

Método(s)

The algorithm was developed in stages, considering the initial anatomical location of the lesion (extra-axial or intra-axial) and subsequent imaging characteristics, such as signal patterns on MRI sequences (T1, T2, FLAIR, and DWI). The segmentation included:

Extra-axial lesions, subdivided based on predominant signals (such as CSF signal, T1 hyperintensity, diffusion restriction, or FLAIR hypointensity).

Intra-axial lesions, classified as intraventricular or parenchymal, and also correlated with clinical history for diagnostic refinement.

Discussão

The proposed algorithm for cystic brain lesions begins with anatomical location and imaging characteristics. Extra-axial lesions with a CSF-like signal include arachnoid and pineal gland cysts, while T1 hyperintensity suggests dermoid, neuroenteric, or Rathke’s cleft cysts. Epidermoid cysts show diffusion restriction, and FLAIR hypointensity with septations is typical of neurocysticercosis. Intra-axial intraventricular lesions include ependymal, connatal, simple, and Blake’s pouch cysts (CSF signal), colloid cysts, and cysticercosis (FLAIR hyperintensity), or xanthogranulomas (DWI restriction). Intra-axial parenchymal lesions involve syndromic conditions, developmental anomalies, sequelae, infections, or neoplasms, where clinical correlation and MRI findings refine the differential diagnosis.

Conclusões

The brain can be affected by a wide group of cystic appearing lesions and to help in the diagnosis by imaging, we organize the main conditions that affect it in an algorithm with an anatomical-based classification.

In the differential diagnosis, clinical data support the etiological diagnosis to the imaging pattern of involvement.

Image evaluation can be done mainly by CT and MRI.

We hope this systematic approach helps less experienced radiologists narrow down the diagnosis of cystic brain lesions.

Palavras Chave

CISTO; Neuroimagem; Ressonância Magnética

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