Axial diffusion-weighted (image 1) and apparent diffusion co | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Axial diffusion-weighted (image 1) and apparent diffusion coefficient (ADC) map (image 2) show the lesion (arrow) of the left middle cranial fossa restricts diffusion. This is a common location for an arachnoid cyst. However, an arachnoid cyst should follow cerebral spinal fluid on all imaging sequences including diffusion-weighted imaging.

Intracranial epidermoid cysts can mimic an arachnoid cyst. They are differentiated from arachnoid cysts by their restricted diffusion. The ADC map helps to confirm that there is true restricted diffusion and not just T2 shine through.

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