Rathke Cleft Cysts:Comparative Study of Pathology,Clinic and Imaging / 实用放射学杂志

ABSTRACT

Objective To study the correlation among pathological,clinical and the imaging features(CT and MRI) of the Rathke cleft cysts.Methods CT,MRI and clinical findings of Rathke cleft cysts in 43 patients confirmed by operation and pathology were retrospectively studied.Results 27 cysts located at intrasella and suprasella and 16 cysts entirely located at intrasella.Cysts were round or oval in shape with definite borders.The size of 30 cysts exceed 10mm in diameter.On CT scans reviewed,the cysts were low density in 9 cases,hyper-density in 9 cases and isodensity or mixed density in 8 cases.The cyst's wall with calcification was seen in one.On postcontrast CT scans,6 cases showed circular and peripheral cyst's wall enhancement and others were no enhancement.On MR imaging,the lesions were low or isodense on T1WI and hyper-intensity on T2WI in 18 cases,both were high signal intensity on T1WI and T2WI in 6 cases,high signal intensity on T1WI and mixed signal intensity on T2WI in 4 cases.An intracystic nodule having high signal intensity on T1WI,and low or mixed signal intensity on T2WI was observed in 4 cases.On contrast-enhanced MR imaging,enhancement of the cyst's wall was shown in 9 cases.During surgery,the lesions were noted to have a cyst of semisolid consistency,and cystic contents were described from CSF-like clear fluid in 10 cases,jellied-like brown mucoid fluid in 15 cases,caseous-like mucoid fluid in 12 cases,machine oil-like mucoid fluid in 6 cases.At histopathology,a part of cystic fluid included cholesterol crystal and necrotic debris.Cholesterol clefts and hemosiderin pigment,and granuloma were shown by staining with HE in 11 cases.The PAS staining was positive in 16 cases,cystic fluid contained partial mucopolysaccharides and protein.Conclusion Typical Rathke cysts can be dignosised in the preoperative,the findings of CT and MRI are not specific in atypical cysts.The imaging features were different with the fluid component of Rathke cleft cysts..