Evidence map›Paper›PMID 40956448›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Limitations of MRI in differentiating solid and cystic components of craniopharyngiomas.

Banu Karaalioğlu, Nazlı Çakıcı Öksüz, Veyselkarani İpek, Aslı Çakır, Osman Kahraman, Muhammet Arif Özbek

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Banu KaraalioğluDepartment of Radiology, İstanbul Medipol University Hospital, TEM Avrupa Otoyolu, Göztepe Çıkışı No:1, 34214, Bağcılar, Istanbul, Turkey. bnkaraalioglu@gmail.com.ORCID 0000-0003-4864-5652
Nazlı Çakıcı ÖksüzDepartment of Neurosurgery, İstanbul University of Health and Technology, Istanbul, Turkey.ORCID 0000-0003-1480-6235
Veyselkarani İpekDepartment of Neurosurgery, İstanbul Medipol University Hospital, Istanbul, Turkey.ORCID 0000-0002-8617-9958
Aslı ÇakırDepartment of Pathology, İstanbul Medipol University Hospital, Istanbul, Turkey.ORCID 0000-0003-0128-6947
Osman KahramanDepartment of Radiology, İstanbul Medipol University Hospital, TEM Avrupa Otoyolu, Göztepe Çıkışı No:1, 34214, Bağcılar, Istanbul, Turkey.ORCID 0000-0002-9412-7306
Muhammet Arif ÖzbekDepartment of Neurosurgery, İstanbul Medipol University Hospital, Istanbul, Turkey.ORCID 0000-0002-1847-2562

Funding

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6 · The paper itself

Abstract

purposeCraniopharyngiomas (CP) present with both solid and cystic structures in magnetic resonance imaging (MRI) studies. Contrary to MRI appearance, components described as cysts are not infrequently found as non-fluent structures during surgery. This study aims to address the discrepancy between radiology and surgery regarding the nature of these lesions and to evaluate them for their preoperative predictability. MATERIALS AND

methodsPreoperative MRI images of 24 CP patients were analyzed. The cystic components of the tumors were assessed in terms of quantitative and qualitative signal properties and contrast enhancement on conventional pulse sequences, and analyzed based on their macroscopic appearances.

resultsThirteen of 31 lesions (42%) that suggested cyst on MRI were solid during surgery, with none showing contrast uptake. MRI demonstrated 100% sensitivity and negative predictive value (NPV), 71.7% specificity, and 58% positive predictive value (PPV) in identifying true cysts. Most lesions resembling cysts were hyperintense on FLAIR and T1WI and isointense on ADC maps, suggesting high protein content. However, surgically confirmed fluid-filled cysts exhibited similar signal characteristics in a comparable proportion. The only significant imaging indicator was a hypointense appearance on T2WI, with a mean intensity ratio close to that of the basal ganglia.

conclusionAccurate identification of solid and cystic components in craniopharyngiomas is critical for effective treatment planning. Although MRI is traditionally considered reliable for this purpose, 42% of lesions that appeared cystic without contrast enhancement were ultimately confirmed as non-fluid or solid during surgery. This study was unable to establish definitive MRI characteristics to reliably differentiate between cystic and solid components. Further research with larger cohorts is warranted to validate potential imaging markers and improve diagnostic accuracy.

Indexed as

CraniopharyngiomaCystsMagnetic Resonance ImagingPituitary NeoplasmsAdolescentAdultChildChild, PreschoolDiagnosis, DifferentialFemaleHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityYoung AdultCraniopharyngiomaCystic craniopharyngiomaMagnetic resonance imaging

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.