title: Digital Subtraction Cystography for Detection of Communicating Holes of Spinal Extradural Arachnoid Cysts.
abstract: OBJECTIVE
  The purpose of this study was to demonstrate the usefulness of digital subtraction cystography to identify communicating holes between a spinal extradural arachnoid cyst (SEAC) and the subarachnoid space prior to cyst removal and hole closure.
  
  
  METHODS
  Six patients with SEAC were enrolled in this retrospective study. Digital subtraction cystography and subsequent CT myelography were performed for every patient. The presence and location of the communicating holes on cystography were documented. We evaluated the MRI characteristics of the cysts, including location, size, and associated spinal cord compression; furthermore, we reviewed cystographic images, CT myelograms, procedural reports, and medical records for analysis. If surgery was performed after cystography, intraoperative findings were compared with preoperative cystography.
  
  
  RESULTS
  The location of the communicating hole between the arachnoid cyst and the subarachnoid space was identified by digital subtraction cystography in all cases (n = 6). Surgical resection of SEAC was performed in 4 patients, and intraoperative location of the communicating hole exactly corresponded to the preoperative identification.
  
  
  CONCLUSIONS
  Fluoroscopic-guided cystography for SEAC accurately demonstrates the presence and location of dural defects. Preoperative digital subtraction cystography is useful for detection of a communicating hole between a cyst and the subarachnoid space.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
authors.forename: Kyowon
authors.initials: K
authors.lastname: Gu
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.; Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul 06351, Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
authors.forename: Eun-Sang
authors.initials: ES
authors.lastname: Kim
mesh_terms: D000328:Adult; D016080:Arachnoid Cysts / Q000000981:diagnostic imaging*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Communicating hole; Computed tomography myelography; Cystography; Magnetic resonance imaging; Spinal extradural arachnoid cyst