Discal cysts

Kathryn Phillips

Discal cysts

• Epidural• Ventrolateral• May communicate with the disc • Concurrent disc disease with herniation or

bulging.• Tightly adhered to anulus fibrosis• Occasionally have mild bone erosion• Occasionally have hemorrhage into cyst

MRI features

T1 – equivalent to fluid T2 - Hyperintense

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Normal spinal canal T2 hyperintense oval structure causing cord compression

MR features

• Discal cyst in a man• Cyst is isointense to CSF• Cyst has a thick wall that

contrast enhances

ImagingCT diskography: communication

between disc and cyst is demonstrated by injecting contrast into the disc space.

Differential diagnoses

• Synovial cyst – dorsolateral to or inseparable from facet joints.

• Perineural cysts – usually close to nerve root, and are thin walled.

• Arachnoid cysts – younger patients, not associated with herniated disc and do not contrast enhance.

References• Konar M, Lang J, Fluhmann, Forterre. MRI appearance of ventral

intraspinal cysts associiated with intervertebral disc in dogs. Abstracts from the annual conference of the European association of veterinary diagnostic imaging. 2008. Vet rad us. 49;2:196-219.

• Lee HK, Lee DH, Choi, CG, Kim SJ, Suh DC, Kahng, Roh, Rhim. Discal cyst of the lumbar spine: MR imaging features. 2006. Clinical imaging 326-330.

• Kono K, Nakamura H, Inoue Y, Okamura T, Shakudo M, and Yamada. Intraspinal Extradural Cysts Communicating with adjacent Herniated Disks: imaging characteristics and possible pathogenesis. 1999 Am j neuroradiol 20:1373-1377