Vertical Triband Flag Sign; a Radiological Feature for Differential Diagnosis of Rathke’s Cleft Cyst

Introduction: The Rathke cleft cyst (RCC) is a type of cystic growth that is benign, circular, and well-defined with an incidence rate of 4%. It originates from the remnants of the Rathke’s pouch and is commonly found in the sellar and suprasellar regions. RCCs are often confused with other cystic growths in the same areas, and this study aims to identify a useful diagnostic imaging sign that can aid in the differentiation of RCC from other cystic lesions.

Methods: We retrospectively analyzed the records of 40 symptomatic RCC patients who were referred to our facility between 2016 and 2023. The data for the study were obtained from our electronic database. All Magnetic resonance imaging (MRI) studies were performed using a 1.5-tesla superconducting magnet scanner.

Results: We analyzed data from 40 patients with symptomatic RCC, comprising 6 (15%) males and 34 (85%) females with a mean age of 39 years old. Our study identified a distinct imaging characteristic in 21 of the cases, which we have named the “vertical triband flag sign”, due to the growth of the cyst developing a specific appearance.

Conclusion : Early diagnosis of RCCs can be facilitated by utilizing the vertical triband flag sign.
Keywords: Rathke’s cleft cyst; Magnetic resonance imaging; Diagnosis