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MRI characteristics of cysts and "cyst-like" lesions in and around the knee: what the radiologist needs to know.

Perdikakis E, Skiadas V - Insights Imaging (2013)

Bottom Line: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee.In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended.For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy. • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, 412 General Military Hospital-212 Mobile Army Surgical Hospital, Terma Lefkou Pyrgou, Xanthi, 67100, Greece, perdikakis_ev@yahoo.gr.

ABSTRACT

Objectives and methods: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee. These lesions comprise a diverse group of entities from benign cysts to complications of underlying diseases. In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended. However, the majority of the aforementioned lesions have characteristic MR appearances that allow a confident diagnosis, thus obviating the need for additional imaging or interventional procedures.

Results: This article includes a comprehensive pictorial essay of the characteristic MRI features of common and uncommon benign cysts and "cyst-like" lesions in and around the knee joint.

Discussion: For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy.

Teaching points: • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

No MeSH data available.


Related in: MedlinePlus

Synovial sarcoma. The sagittal (a) and axial (b) fat saturated proton density weighted images show a multilocular “cyst-like” lesion near the knee joint (white arrows). The axial (c) T1-weighted and the axial (d) fat saturated contrast-enhanced T1-weighted images aided in the differential diagnosis by showing the solid nature of the tumour. The lesion demonstrated intense contrast enhancement except for a peripherally located necrotic part (grey arrows)
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Fig26: Synovial sarcoma. The sagittal (a) and axial (b) fat saturated proton density weighted images show a multilocular “cyst-like” lesion near the knee joint (white arrows). The axial (c) T1-weighted and the axial (d) fat saturated contrast-enhanced T1-weighted images aided in the differential diagnosis by showing the solid nature of the tumour. The lesion demonstrated intense contrast enhancement except for a peripherally located necrotic part (grey arrows)

Mentions: In addition, administration of intravenous contrast is primarily helpful in the evaluation of soft tissue masses and particularly in differentiating cysts from malignant pseudocystic conditions [9–13]. Solid tumours with central necrosis, cystic degeneration or myxoid stroma such as synovial sarcoma, dedifferentiated sarcoma, myxoid liposarcoma, metastases and the benign synovial haemangioma may have homogeneously high signal on T2-weighted images mimicking a cyst, but they enhance after contrast administration contrary to the cysts (Fig. 26).Fig. 26


MRI characteristics of cysts and "cyst-like" lesions in and around the knee: what the radiologist needs to know.

Perdikakis E, Skiadas V - Insights Imaging (2013)

Synovial sarcoma. The sagittal (a) and axial (b) fat saturated proton density weighted images show a multilocular “cyst-like” lesion near the knee joint (white arrows). The axial (c) T1-weighted and the axial (d) fat saturated contrast-enhanced T1-weighted images aided in the differential diagnosis by showing the solid nature of the tumour. The lesion demonstrated intense contrast enhancement except for a peripherally located necrotic part (grey arrows)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3675245&req=5

Fig26: Synovial sarcoma. The sagittal (a) and axial (b) fat saturated proton density weighted images show a multilocular “cyst-like” lesion near the knee joint (white arrows). The axial (c) T1-weighted and the axial (d) fat saturated contrast-enhanced T1-weighted images aided in the differential diagnosis by showing the solid nature of the tumour. The lesion demonstrated intense contrast enhancement except for a peripherally located necrotic part (grey arrows)
Mentions: In addition, administration of intravenous contrast is primarily helpful in the evaluation of soft tissue masses and particularly in differentiating cysts from malignant pseudocystic conditions [9–13]. Solid tumours with central necrosis, cystic degeneration or myxoid stroma such as synovial sarcoma, dedifferentiated sarcoma, myxoid liposarcoma, metastases and the benign synovial haemangioma may have homogeneously high signal on T2-weighted images mimicking a cyst, but they enhance after contrast administration contrary to the cysts (Fig. 26).Fig. 26

Bottom Line: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee.In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended.For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy. • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, 412 General Military Hospital-212 Mobile Army Surgical Hospital, Terma Lefkou Pyrgou, Xanthi, 67100, Greece, perdikakis_ev@yahoo.gr.

ABSTRACT

Objectives and methods: A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging (MRI) of the knee. These lesions comprise a diverse group of entities from benign cysts to complications of underlying diseases. In addition, normal anatomic bursae and recesses may be misdiagnosed as an intra-articular cystic lesion when they are distended. However, the majority of the aforementioned lesions have characteristic MR appearances that allow a confident diagnosis, thus obviating the need for additional imaging or interventional procedures.

Results: This article includes a comprehensive pictorial essay of the characteristic MRI features of common and uncommon benign cysts and "cyst-like" lesions in and around the knee joint.

Discussion: For accurate assessment of the "cystic structure", a radiologist should be able to identify typical MRI patterns that contribute in establishing the correct diagnosis and thus guiding specific therapy and avoiding unwarranted interventional procedures such as biopsy or arthroscopy.

Teaching points: • Cystic lesions are common in knee MRI and the commonest, the Baker's cyst, has an incidence of 38 %. • Synovial cysts, meniscal cysts, normal knee bursae and recesses have characteristic MR appearances. • Miscellaneous "cyst-like" lesions may require a more dedicated MR protocol for a correct diagnosis.

No MeSH data available.


Related in: MedlinePlus