[The sacral perineural system--are there radiological criteria for an indication for surgery? First results and literature survey].
OBJECTIVE
To establish recommendations for diagnostic imaging of cystic lesions of the sacral region and to evaluate for potential predictors of therapeutic outcome.


METHODS
Conventional imaging of the lumbar spine, conventional CT, myelography, post myelo-CT and MRI were performed in 7 symptomatic [corrected] patients. All patients underwent operative decompression and histological examination. The radiographic examinations were reevaluated retrospectively and correlated with the postoperative outcome.


RESULTS
In one patient the differential diagnosis of a neurinoma could not be excluded with CT and CT-myelography alone. In all 7 patients MRI provided a definite diagnosis and a precise presentation of the cyst extension. A complete postoperative remission of symptoms was noticed in 4, a partial remission in three cases. The correlation of cyst extension, cyst shape, and the communication with the subarachnoid space did not provide predictive information concerning operative outcome.


CONCLUSIONS
MR can be used as the sole imaging tool for demonstration of cystic lesions. Relevant disadvantages in comparison to myelography and myelo-CT were not evident. No imaging modality could predict the value of surgical intervention.
Nikolic
B
B
Institut für Radiologie und Radiologische Diagnostik der Universität zu Köln. Nikolib@gusun.georgetown.edu
Abbara
S
S
Heindel
W
W
Volz
M
M
Terstegge
K
K
Klug
N
N
Lackner
K
K
D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D052958:Tarlov Cysts / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
Sakrale Perineuralzysten--gibt es radiologische Kriterien für eine Operationsindikation? Eigene Ergebnisse und Literaturübersicht.