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. 2022 Nov;31(11):3146-3158.
doi: 10.1007/s00586-022-07337-1. Epub 2022 Aug 10.

Multiple dimensions of radiographic reconstruction for the optimal operative strategy of sacral meningeal cysts

Qianquan Ma #  1 , Jingcheng Xie #  1 , Chenlong Yang  1 , Chao Wu  1 , Jia Zhang  1 , Xiaoliang Yin  1 , Yu Si  1 , Ying Liu  2 , Jun Yang  1 , Jianjun Sun  3
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Multiple dimensions of radiographic reconstruction for the optimal operative strategy of sacral meningeal cysts

Qianquan Ma et al. Eur Spine J. 2022 Nov.

Abstract

Background and purpose: The contents and subtypes of sacral cysts are sophisticated in many cases. We applied multiple dimensional magnetic resonance imaging (MRI) reconstruction to preoperatively clarify the specific subtype of sacral meningeal cysts.

Materials and methods: We preoperatively used multimodal neural reconstruction MRI sequences to evaluate 76 patients with sacral cysts. The linear nerve roots were precisely traced based on sagittal or coronal images processed at various angles and levels which was conducive to the design of the operation strategy.

Results: Cysts with nerve passage were detected in 47 cases (62%, 47/76), whereas cysts without nerve roots were detected in 24 cases (32%, 24/76). Five patients had mixed cysts with or without nerve roots. Intraoperative exploration results proved the high accuracy of image reconstruction; only one cyst without a nerve root was misdiagnosed prior to surgery.

Conclusion: MRI reconstruction based on the three-dimensional fast imaging employing steady-state acquisition T2 sequence precisely tracked the nerve roots of sacral cysts and guided the optimal strategy during surgery.

Keywords: MRI reconstruction; Meningeal diverticula; Sacral cysts; Tarlov cyst.

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