Characteristics of Rathke's cleft cyst in MR imaging.
OBJECTIVE
Symptoms, macroscopic appearances and microscopic findings of Rathke's cleft cysts with magnetic resonance (MR) imaging.


METHODS
We analyzed the data from 31 patients with pathologically confirmed Rathke's cleft cysts. MR appearances were evaluated on T1WI, T2WI and contrast T1WI. Symptoms, macroscopic appearances and pathological findings were obtained from available medical records. We analyzed the images according to the following criteria: 1. findings on the location and shape of the lesions and form of the lesional wall; 2. the relationship between the maximum diameter of the lesions and symptoms; 3. the relationship between MR and macroscopic appearance; 4. the sites of adjacent contrast enhancement.


RESULTS
The lesions were located mostly in both the intrasellar and suprasellar regions for a total of 87%. All lesions revealed either an oval or dumbbell shape with a smooth lesional wall. When correlated with physical symptoms, asymptomatic cases were associated with smaller lesions, while visual disturbances and dizziness were associated with relatively larger lesions. MR lesion signal intensity was related to the content of macroscopic appearance to some degree: the selected lesions showed shortening of T1 and T2 relaxation times in relation to the increase in protein concentration. This should have been macroscopically reflected in the color and turbidity of the liquid within the cyst. Adjacent contrast enhancement around the lesion was found at various sites, but anterior enhancement was most frequent. Circumferential enhancement was revealed to be derived from inflammatory changes.


CONCLUSIONS
Rathke's cleft cyst exhibits a varied MR signal. It may be difficult to differentiate from craniopharyngioma from the intensity alone.
Tominaga
Jun-Ya
JY
Division of diagnostic Radiology, Tohoku University, Sendai, Japan. jrtomi@jf6.so-net.ne.jp
Higano
Shuichi
S
Takahashi
Shoki
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D020863:Central Nervous System Cysts / Q000473:pathology*; D003287:Contrast Media; D003397:Craniopharyngioma / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA