Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Digital Subtraction Cystography for Detection of Communicating Holes of Spinal Extradural Arachnoid Cysts

  • Gu, Kyowon (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, Jong Won (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Eun-Sang (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2015.07.29
  • Accepted : 2015.08.31
  • Published : 2016.02.01
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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. Materials and 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. Conclusion: 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.

Keywords

References

  1. Liu JK, Cole CD, Kan P, Schmidt MH. Spinal extradural arachnoid cysts: clinical, radiological, and surgical features. Neurosurg Focus 2007;22:E6
  2. McCrum C, Williams B. Spinal extradural arachnoid pouches. Report of two cases. J Neurosurg 1982;57:849-852 https://doi.org/10.3171/jns.1982.57.6.0849
  3. Congia S, Coraddu M, Tronci S, Nurchi G, Fiaschi A. Myelographic and MRI appearances of a thoracic spinal extradural arachnoid cyst of the spine with extra- and intraspinal extension. Neuroradiology 1992;34:444-446 https://doi.org/10.1007/BF00596513
  4. Ishibe T, Senzoku F, Ikeda N, Kamba Y, Mikawa Y. Detection of the communicating hole(s) of spinal extradural arachnoid cysts using time-spatial labeling inversion pulse magnetic resonance imaging. Spine (Phila Pa 1976) 2014;39:E1394-E1397 https://doi.org/10.1097/BRS.0000000000000591
  5. Rimmelin A, Clouet PL, Salatino S, Kehrli P, Maitrot D, Stephan M, et al. Imaging of thoracic and lumbar spinal extradural arachnoid cysts: report of two cases. Neuroradiology 1997;39:203-206 https://doi.org/10.1007/s002340050394
  6. Doita M, Nishida K, Miura J, Takada T, Kurosaka M, Fujii M. Kinematic magnetic resonance imaging of a thoracic spinal extradural arachnoid cyst: an alternative suggestion for exacerbation of symptoms during straining. Spine (Phila Pa 1976) 2003;28:E229-E233
  7. Tomii M, Mizuno J, Takeda M, Matsushima T, Itoh Y, Numazawa S, et al. Thoracolumbar extradural arachnoid cyst--three surgical case reports. Neurol Med Chir (Tokyo) 2013;53:129-133 https://doi.org/10.2176/nmc.53.129
  8. Neo M, Koyama T, Sakamoto T, Fujibayashi S, Nakamura T. Detection of a dural defect by cinematic magnetic resonance imaging and its selective closure as a treatment for a spinal extradural arachnoid cyst. Spine (Phila Pa 1976) 2004;29:E426-E430 https://doi.org/10.1097/01.brs.0000141189.41705.70
  9. Miyamoto M, Kim K, Matsumoto R, Isobe M, Isu T. Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts: case report. Neurosurgery 2006;59:E941; discussion E941 https://doi.org/10.1227/01.NEU.0000232659.56174.28
  10. Funao H, Nakamura M, Hosogane N, Watanabe K, Tsuji T, Ishii K, et al. Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine. Neurosurgery 2012;71:278-284; discussion 284 https://doi.org/10.1227/NEU.0b013e318257bf74
  11. Yoshida H, Takai K, Taniguchi M. Leakage detection on CT myelography for targeted epidural blood patch in spontaneous cerebrospinal fluid leaks: calcified or ossified spinal lesions ventral to the thecal sac. J Neurosurg Spine 2014;21:432-441 https://doi.org/10.3171/2014.5.SPINE13549
  12. Qi W, Zhao L, Fang J, Chang X, Xu Y. Clinical characteristics and treatment strategies for idiopathic spinal extradural arachnoid cysts: a single-center experience. Acta Neurochir (Wien) 2015;157:539-545 https://doi.org/10.1007/s00701-014-2278-3

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