MR imaging of Tornwaldt's cysts

OBJECTIVE. The purpose of this study was to assess the characteristics of T ornwaldt's cysts as revealed by routine MR studies. MATERIALS AND METHODS. We retrospectively reviewed MR images of the brain i n 1208 consecutive subjects who ranged in age from 3 weeks to 93 years (mea n, 57.1 years). The signal intensity, shape, and size of Tornwaldt's cysts were assessed. Patients with Tomwaldt's cysts were then questioned about th e presence of persistent nasal discharge, occipital headaches, and halitosi s and an unpleasant taste in the mouth and about a history of adenoidectomy . RESULTS. Tomwaldt's cysts were found in 23 patients (1.9%) who ranged in ag e from 39 to 78 years (mean, 57.3 years). Of the 23 Tomwaldt's cysts, all w ere isointense to CSF on T2-weighted images and hyperintense to gray matter on the fluid-attenuated inversion-recovery images. The cysts showed high s ignal intensity compared with muscle on T1-weighted images. Nineteen cysts were round and four were oval. The mean size of the lesions was 6.0 mm in t he major axis and 5.5 mm in the minor axis. Two patients with Tornwaldt's c ysts had persistent nasal discharge and occipital headaches, and another pa tient had occipital headaches alone. None of the patients had undergone an adenoidectomy. CONCLUSION. Lesions consistent with Tornwaldt's cysts were found in 1.9% of the routine MR studies of the brain. The cysts had high signal intensity o n T1-weighted, T2-weighted, and fluid-attenuated inversion-recovery images.