Intracranial neurenteric cyst

Intracranial neurenteric cysts (also sometimes spelled neuroenteric) are developmental CNS lesions arising from endoderm.

Pathology

They result from incomplete resorption of the neurenteric canal, a temporary connection between the yolk sac and amnion during early embryogenesis. Intracranial neurenteric cysts are extra-axial and in 80% of cases are in the posterior fossa anterior to the pontomedullary junction and 20% in the supratentorium adjacent to the frontal lobes. Intracranial neurenteric cysts are much less common than spinal neurenteric cysts.

Radiographic features

CT

Iso- to slightly hyper-attenuating compared to CSF with no enhancement.

MRI

MRI is the modality of choice, and appearances depend on the variable protein content:

• T1: iso to hyperintense to CSF
• T2: hyperintense to CSF
• FLAIR: does not suppress
• DWI/ADC: facilitated diffusion

Differential diagnosis

Imaging differential considerations include:

• epidermoid cyst
  • similar to CSF in signal
  • high DWI signal, ADC similar to brain parenchyma
• arachnoid cyst
  • CSF signal on all sequences
• cystic schwannoma
  • solid enhancing component
• intracranial lipoma
  • fat signal on all sequences
  • suppression on fat-suppressed sequences
• ecchordosis physaliphora
  • a stalk-like connection to the clivus
  • variable enhancement
• chordoma
  • usually enhances following IV contrast

Siehe auch:

• Ecchordosis physaliphora
• neuroenterische Zyste
• zystische Läsion im Klivus

und weiter:

• Raumforderungen des Clivus