Steady-state coherent imaging sequence in MRI is useful in the diagnosis of choroid plexus cyst : a case report

Abstract

  Choroid plexus cysts (CPCs) are common neuroepithelial cysts that are typically small and asymptomatic, and are discovered incidentally. Symptomatic CPCs are rare. CPCs are difficult to detect on routine computed tomography (CT) and magnetic resonance imaging (MRI) scans, because of their thin non-enhancing walls and cerebrospinal fluid (CSF)-like fluid content. The authors report a case of symptomatic CPC diagnosed with steady-state coherent imaging sequence in a 2-year-old boy who presented with status epilepticus. Although he underwent emergency ventricular drainage for acute hydrocephalus, conventional MRI demonstrated no obvious lesions immediately after the operation. We used steady-state coherent imaging sequence to investigate his continuous intracranial hypertension postoperatively, and a unilocular cystic lesion in the third ventricule, occluding the cerebral aqueduct was detected. Subsequently, he underwent endoscopic resection of the cyst with third ventriculostomy, and recovered his consciousness. Wall biopsy indicated CPC. Steady-state coherent imaging sequence has the advantage of excellent spatial resolution and fewer artifacts of vessel pulsation and CSF flow, and enables the visualization of flow abnormalities in CSF pathways or small intraventricular lesions. If routine CT and MRI reveal hydrocephalus of unknown origin, steady-state coherent imaging sequence can be useful for the precise identification of lesions.