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Cross-sectional imaging usually enables the diagnosis to be made with confidence. MRI is superior to CT in fully characterizing the lesion. On all modalities, colloid cysts appear as a rounded, sharply demarcated lesion at the foramen of Monro, which range in size from a few millimeters to 3-4 cm 3.
Colloid cyst. mri. A hyperdense (on CT) rounded colloid cyst (green arrow) is present in the roof of the third ventricle (yellow dotted line). The content of the cyst is hyperintense on T1 and markedly hypointense on T2 and FLAIR.
Colloid nodules are composed of irregularly enlarged follicles containing abundant colloid. A colloid nodule may be single or multiple and can vary considerably in size. Some colloid nodules can be cystic (cystic colloid nodule) and may contain areas of necrosis, hemorrhage and/or calcification.
This MRI demonstrates typical characteristics of a third ventricular colloid cyst. Whereas the appearance on CT (not shown) is quite predictable, appearing as hyperdense non-enhancing nodule at the foramen of Monro in the roof of the third ventricle, on MRI signal characteristics are much more variable, depending on the composition of the cyst ...
This case illustrates the typical appearance of a colloid cyst, a very important finding as they are associated with sudden death, and patients need to be referred for surgical assessment.
MRI demonstrates a large cyst at the foramen of Munro with low T1 signal (higher than CSF), high T2 which does not attenuate on FLAIR, and with no restricted diffusion. No convincing solid enhancement can be demonstrated although a small nodule is of high T1 and low T2 signal.
Selected images from an MRI. In the roof of the third ventricle is a rounded lesion with low T2 and high T1 signal. No hydrocephalus. This is a characteristic appearance of a colloid cyst of the third ventricle.
A location-based approach is useful in establishing an appropriate diagnosis; some locations are virtually pathognomonic for certain lesions e.g. colloid cyst. Many cysts may occur in more than one location (midline or off-midline) e.g. arachnoid and epidermoid cysts.
Pineal cysts are typically found in young adults (20-30 years of age) with a predilection for women (3:1 female to male ratio). They are seen in ~5% of brain MRIs and 20-40% of autopsy series. In high-resolution MRIs, a study found a high prevalence of asymptomatic cysts in 23% of healthy subjects 6.