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Epidermoid Versus Arachnoid Cyst
A 33-year-old woman with a history of chronic headaches. DWI, diffusion-weighted imaging; FLAIR, fluid attenuated inversion recovery.
A 74-year-old woman with a history of unsteady gait. DWI, diffusion-weighted imaging; FLAIR, fluid attenuated inversion recovery.
DESCRIPTION OF FINDINGS
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Scans demonstrate two different pineal region extraaxial masses roughly following CSF intensity: hypointense on T1-weighted images and hyperintense on T2-weighted images.
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Closer inspection demonstrates that the lesion in Case A has crenulated, irregular margins compared with the smoothly marginated contours of the lesion in Case B.
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In addition, in Case A, the lesion is hyperintense compared with CSF on FLAIR and DWI. In contrast, the internal signal characteristics of the lesion in Case B are isointense compared with CSF on all sequences, including the FLAIR and DWI sequences.
Diagnosis
Case A
Epidermoid cyst (bright on DWI)
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