Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: Is diffusion-weighted MRI useful?

Kamlesh Kukreja, Glen Manzano, John Ragheb, L. Santiago Medina

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Background: Appropriate differentiation between epidermoid-dermoid and arachnoid cysts is important for patient management. MRI has had limitations in differentiating these two types of cysts, especially in the region of the spinal cord. Objective: To evaluate the role of diffusion-weighted (DW) MRI for differentiation between spinal arachnoid and epidermoid-dermoid cysts. Materials and methods: Four children underwent conventional and DW MRI. Turbo spin-echo imaging was used to obtain DW images. Results: On conventional MRI, low T1-W and high T2-W signal was present in all lesions. DW imaging showed restricted diffusion in two patients with epidermoid-dermoid cysts and no water restriction in two patients with arachnoid cysts. Three of four children had extramedullary lesions and one patient had an intramedullary lesion. Three children had surgery, two with epidermoid-dermoid cysts and one with arachnoid cyst. Diagnosis was confirmed by histopathology. One child with a thoracic arachnoid cyst had stable clinical imaging findings during a follow-up of 21 months. Conclusion: On conventional MRI, epidermoid-dermoid and a rachnoid cysts have similar signal characteristics. Initial experience with spine DW imaging shows promise in differentiating epidermoid-dermoid cysts from arachnoid cysts. Preoperative differentiation is important because it changes management and surgical approach.

Original languageEnglish (US)
Pages (from-to)556-560
Number of pages5
JournalPediatric radiology
Issue number6
StatePublished - Jun 2007


  • Arachnoid cyst
  • Children
  • Dermoid-epidermoid
  • MRI
  • Spine

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology


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