Department of Radiology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, USA.
AJNR Am J Neuroradiol. 2013 Aug;34(8):1661-4. doi: 10.3174/ajnr.A3441. Epub 2013 Feb 28.
Lumbar facet synovial cysts are a cause of back pain and radiculopathy with facet joint degeneration, the most common cause for cyst formation. Typically, LFSCs are T2 hyperintense on MR imaging, but the signal intensity is variable. Treatment options include percutaneous rupture and surgical resection. This study evaluates the relationship between LFSC signal intensity on MR imaging and outcomes as it relates to percutaneous rupture success and need for subsequent surgery.
A retrospective review of 110 patients who underwent CT fluoroscopic-guided rupture of symptomatic LFSCs was performed. The LFSCs were characterized by their T2 signal intensity on MR imaging and divided into 3 groups: high, intermediate, and low T2 signal intensity. The rates of successful cyst rupture and need for subsequent surgery were recorded.
Percutaneous LFSC rupture was technically successful in 87% of all cases. Cyst rupture was successful in 89% and 90% of high and intermediate signal intensity cysts, respectively, and in 65% of low signal intensity cysts (P = .017, .030). High signal intensity cysts had lower postprocedural surgical rates (29%) when compared with intermediate and low signal cyst as a group (P = .045).
T2 hyperintense and intermediate signal intensity LFSCs are easier to rupture, perhaps because the cysts contain a higher proportion of fluid and are less gelatinous or calcified than T2 hypointense cysts. Patients with T2 hyperintense LFSCs are less likely to need surgery.
腰椎小关节滑膜囊肿是一种由小关节退变引起的腰痛和根性病变的原因，是囊肿形成的最常见原因。通常，腰椎小关节滑膜囊肿在磁共振成像（MR）上表现为 T2 高信号，但信号强度是可变的。治疗选择包括经皮破裂和手术切除。本研究评估了腰椎小关节滑膜囊肿 MR 成像信号强度与经皮破裂成功率和后续手术需求之间的关系。
对 110 例接受 CT 荧光引导下症状性腰椎小关节滑膜囊肿破裂的患者进行了回顾性研究。腰椎小关节滑膜囊肿的 T2 信号强度在 MR 成像上表现为高、中、低信号强度，并分为 3 组。记录囊肿破裂的成功率和后续手术的需求。
所有病例中，经皮腰椎小关节滑膜囊肿破裂技术成功率为 87%。高、中信号强度囊肿的囊肿破裂成功率分别为 89%和 90%，低信号强度囊肿的破裂成功率为 65%（P=0.017，0.030）。与中、低信号强度囊肿组相比，高信号强度囊肿的术后手术率较低（29%比 49%，P=0.045）。
T2 高信号和中等信号强度的腰椎小关节滑膜囊肿更容易破裂，这可能是因为囊肿内含有更高比例的液体，并且比 T2 低信号囊肿更胶状或钙化。T2 高信号腰椎小关节滑膜囊肿患者更不需要手术。
