Presentation
Seizures.
Patient Data
Age: 50 years
Gender: Female
From the case:
Neuroglial cyst
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Small well-defined subcortical partially septated cystic lesion of the left frontal lobe measuring 12 X 9 X 6 mm, eliciting of low signal intensity on T1 and FLAIR, high signal on T2 and FLAIR with no restricted diffusion (CSF signal). No peripheral enhancement or surrounding edema or gliosis.
Small vessel ischemic changes are noted.
Case Discussion
MRI features left subcortical cystic lesion with no restricted diffusion or enhancement suggestive of a neuroglial cyst.
On imaging, the main differential considerations include:
-
porencephalic cyst
- usually shows surrounding gliosis
- communicates with the lateral ventricle
-
dysembryoplastic neuroepithelial tumor (DNET)
- typically of cortical location
- mixed signal intensity on FLAIR with bright rim sign
-
multinodular and vaculating neuronal tumor (MVNT)
- cluster of well-circumscribed high T2 signal "bubbles"
- high signal on FLAIR
-
arachnoid cyst
- typically extra-axial
-
enlarged perivascular space
- typically multiple
- cluster around the basal ganglia
-
neurocysticercosis
- usually <1 cm
- partially enhance
-
cerebral hydatid cyst
- usually spherical
- may be indistinguishable
-
ependymal cyst
- periventricular
- may be indistinguishable
-
epidermoid cyst
- restricted diffusion
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