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[Lumbar intraspinal juxtafacet cysts: MR imaging and CT-arthrography].
Rofo. 2002 Oct; 174(10):1247-52.ROFO

Abstract

PURPOSE

To present data on the MR imaging appearance of lumbar intraspinal juxtafacet cysts (JFC) and to assess the importance of additional CT arthrography.

MATERIAL AND METHODS

Twenty-eight patients (16 women, 12 men) with a mean age of 64 years (range: 43 - 82), who underwent MR imaging because of radicular pain or spinal claudication, were found to have an intraspinal cyst associated with the facet joint. In 14 patients, additional CT-arthrography was performed to determine whether a communication exists between the cyst and the facet joint and to try to rupture the cyst.

RESULTS

In T(2)-weighted images, juxtafacet cysts show a typical pattern consisting of a hyperintense center and hypointense rim. The center is likely to be inhomogeneous because of recurrent hemorrhage in the cyst. In T1-weighted images, the cysts are hypo/isointense. Irregular hyperintensity may indicate subacute hemorrhage, which may aggravate the clinical symptoms. MR allows superior visualization of the cyst in all anatomical planes. It also enables assessment of typical accompanying changes, such as degenerative spondylolisthesis and facet hypertrophy. All patients, who had CT-arthrography, were found to have a direct communication between joint space and cyst. Transarticular rupture of the cyst was possible in five patients. Two of these five patients had good to excellent improvement, and the remaining three patients underwent surgery.

CONCLUSION

MR imaging is the method of choice for diagnosing lumbar intraspinal juxtafacet cysts. CT-arthrography of the facet joint is helpful in cases with difficult differential diagnosis, and in the preoperative planning. Furthermore, it assists in the primary interventional treatment.

Authors+Show Affiliations

Schmid G
Klinik für Radiologie und Nuklearmedizin, St. Josef-Hospital, Ruhr-Universität Bochum. Gerhard.Schmid@ruhr-uni-bochum.de
Willburger R
No affiliation info available
Jergas M
No affiliation info available
Pennekamp W
No affiliation info available
Bickert U
No affiliation info available
Köster O
No affiliation info available

MeSH

AdultAgedAged, 80 and overArthrographyBone CystsDiagnosis, DifferentialFemaleHumansLumbar VertebraeMagnetic Resonance ImagingMaleMiddle AgedSpinal DiseasesSpondylolisthesisSynovial CystTomography, X-Ray ComputedZygapophyseal Joint

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ger

PubMed ID

12375197

Citation

Schmid, G, et al. "[Lumbar Intraspinal Juxtafacet Cysts: MR Imaging and CT-arthrography]." RoFo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin, vol. 174, no. 10, 2002, pp. 1247-52.
Schmid G, Willburger R, Jergas M, et al. [Lumbar intraspinal juxtafacet cysts: MR imaging and CT-arthrography]. Rofo. 2002;174(10):1247-52.
Schmid, G., Willburger, R., Jergas, M., Pennekamp, W., Bickert, U., & Köster, O. (2002). [Lumbar intraspinal juxtafacet cysts: MR imaging and CT-arthrography]. RoFo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin, 174(10), 1247-52.
Schmid G, et al. [Lumbar Intraspinal Juxtafacet Cysts: MR Imaging and CT-arthrography]. Rofo. 2002;174(10):1247-52. PubMed PMID: 12375197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Lumbar intraspinal juxtafacet cysts: MR imaging and CT-arthrography]. AU - Schmid,G, AU - Willburger,R, AU - Jergas,M, AU - Pennekamp,W, AU - Bickert,U, AU - Köster,O, PY - 2002/10/11/pubmed PY - 2002/11/26/medline PY - 2002/10/11/entrez SP - 1247 EP - 52 JF - RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin JO - Rofo VL - 174 IS - 10 N2 - PURPOSE: To present data on the MR imaging appearance of lumbar intraspinal juxtafacet cysts (JFC) and to assess the importance of additional CT arthrography. MATERIAL AND METHODS: Twenty-eight patients (16 women, 12 men) with a mean age of 64 years (range: 43 - 82), who underwent MR imaging because of radicular pain or spinal claudication, were found to have an intraspinal cyst associated with the facet joint. In 14 patients, additional CT-arthrography was performed to determine whether a communication exists between the cyst and the facet joint and to try to rupture the cyst. RESULTS: In T(2)-weighted images, juxtafacet cysts show a typical pattern consisting of a hyperintense center and hypointense rim. The center is likely to be inhomogeneous because of recurrent hemorrhage in the cyst. In T1-weighted images, the cysts are hypo/isointense. Irregular hyperintensity may indicate subacute hemorrhage, which may aggravate the clinical symptoms. MR allows superior visualization of the cyst in all anatomical planes. It also enables assessment of typical accompanying changes, such as degenerative spondylolisthesis and facet hypertrophy. All patients, who had CT-arthrography, were found to have a direct communication between joint space and cyst. Transarticular rupture of the cyst was possible in five patients. Two of these five patients had good to excellent improvement, and the remaining three patients underwent surgery. CONCLUSION: MR imaging is the method of choice for diagnosing lumbar intraspinal juxtafacet cysts. CT-arthrography of the facet joint is helpful in cases with difficult differential diagnosis, and in the preoperative planning. Furthermore, it assists in the primary interventional treatment. SN - 1438-9029 UR - https://www.unboundmedicine.com/medline/citation/12375197/[Lumbar_intraspinal_juxtafacet_cysts:_MR_imaging_and_CT_arthrography]_ DB - PRIME DP - Unbound Medicine ER -