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Magnetic resonance imaging of pineal region tumours.

Fang AS, Meyers SP - Insights Imaging (2013)

Bottom Line: Pineal lesions include germ cell tumours, neoplasms arising from the pineal parenchyma, as well as other pineal region masses.A variety of cases of pineal lesions are presented.Knowledge of the imaging characteristics and clinical features of varying pineal lesions can assist in narrowing the differential diagnosis for more accurate and rational therapeutic planning. • Pineal parenchymal tumours show an "explosion" of normal pineal calcifications towards the periphery. • Pineoblastomas often have restricted diffusion, with apparent diffusion coefficient (ADC) values lower than germinomas. • Pineal teratomas and pineal lipomas display fat signal characteristics and fat saturation on MRI. • Pineal lesions in patients with known malignancy should raise suspicion of metastatic involvement. • Pineal cysts and arachnoid cysts show MRI signal characteristics similar to cerebrospinal fluid (CSF).

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging Sciences, University of Rochester Medical Center School of Medicine and Dentistry, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA, adam_fang@urmc.rochester.edu.

ABSTRACT

Objectives: Pineal lesions can present as a heterogeneous collection of benign and malignant disease conditions. Pineal lesions include germ cell tumours, neoplasms arising from the pineal parenchyma, as well as other pineal region masses.

Methods: A variety of cases of pineal lesions are presented. The important clinical features and typical imaging findings of each pineal lesion are described with emphasis on their morphological appearance and signal intensity characteristics on magnetic resonance imaging (MRI).

Conclusion: Knowledge of the imaging characteristics and clinical features of varying pineal lesions can assist in narrowing the differential diagnosis for more accurate and rational therapeutic planning.

Teaching points: • Pineal parenchymal tumours show an "explosion" of normal pineal calcifications towards the periphery. • Pineoblastomas often have restricted diffusion, with apparent diffusion coefficient (ADC) values lower than germinomas. • Pineal teratomas and pineal lipomas display fat signal characteristics and fat saturation on MRI. • Pineal lesions in patients with known malignancy should raise suspicion of metastatic involvement. • Pineal cysts and arachnoid cysts show MRI signal characteristics similar to cerebrospinal fluid (CSF).

No MeSH data available.


Related in: MedlinePlus

Pineal melanoma in a 65-year-old woman with diplopia and worsening hearing loss. The tumour (arrow) has lobulated, circumscribed margins, and demonstrates heterogeneous predominately high signal on sagittal T1-weighted image (a), and low to intermediate signal on axial T2-weighted image (b). The tumour shows prominent contrast enhancement on axial T1-weighted image (c) as well as invasion of the medial right temporal lobe
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Fig13: Pineal melanoma in a 65-year-old woman with diplopia and worsening hearing loss. The tumour (arrow) has lobulated, circumscribed margins, and demonstrates heterogeneous predominately high signal on sagittal T1-weighted image (a), and low to intermediate signal on axial T2-weighted image (b). The tumour shows prominent contrast enhancement on axial T1-weighted image (c) as well as invasion of the medial right temporal lobe

Mentions: Pineal melanomas can present as either melanotic or amelanotic MRI patterns. Melanotic MRI patterns are the most common pattern with slightly-high to high signal on T1-weighted images and low to intermediate signal on T2-weighted images (Fig. 13). This effect is secondary to melanin free-radicals, which produce a paramagnetic effect and shorten the T1 relaxation time. Amelanotic MRI patterns occur in tumours with less than 10 % melanin-containing cells and often show low-intermediate signal on T1-weighted images and high signal on T2-weighted images [34]. These tumours typically demonstrate contrast enhancement.Fig. 13


Magnetic resonance imaging of pineal region tumours.

Fang AS, Meyers SP - Insights Imaging (2013)

Pineal melanoma in a 65-year-old woman with diplopia and worsening hearing loss. The tumour (arrow) has lobulated, circumscribed margins, and demonstrates heterogeneous predominately high signal on sagittal T1-weighted image (a), and low to intermediate signal on axial T2-weighted image (b). The tumour shows prominent contrast enhancement on axial T1-weighted image (c) as well as invasion of the medial right temporal lobe
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3675249&req=5

Fig13: Pineal melanoma in a 65-year-old woman with diplopia and worsening hearing loss. The tumour (arrow) has lobulated, circumscribed margins, and demonstrates heterogeneous predominately high signal on sagittal T1-weighted image (a), and low to intermediate signal on axial T2-weighted image (b). The tumour shows prominent contrast enhancement on axial T1-weighted image (c) as well as invasion of the medial right temporal lobe
Mentions: Pineal melanomas can present as either melanotic or amelanotic MRI patterns. Melanotic MRI patterns are the most common pattern with slightly-high to high signal on T1-weighted images and low to intermediate signal on T2-weighted images (Fig. 13). This effect is secondary to melanin free-radicals, which produce a paramagnetic effect and shorten the T1 relaxation time. Amelanotic MRI patterns occur in tumours with less than 10 % melanin-containing cells and often show low-intermediate signal on T1-weighted images and high signal on T2-weighted images [34]. These tumours typically demonstrate contrast enhancement.Fig. 13

Bottom Line: Pineal lesions include germ cell tumours, neoplasms arising from the pineal parenchyma, as well as other pineal region masses.A variety of cases of pineal lesions are presented.Knowledge of the imaging characteristics and clinical features of varying pineal lesions can assist in narrowing the differential diagnosis for more accurate and rational therapeutic planning. • Pineal parenchymal tumours show an "explosion" of normal pineal calcifications towards the periphery. • Pineoblastomas often have restricted diffusion, with apparent diffusion coefficient (ADC) values lower than germinomas. • Pineal teratomas and pineal lipomas display fat signal characteristics and fat saturation on MRI. • Pineal lesions in patients with known malignancy should raise suspicion of metastatic involvement. • Pineal cysts and arachnoid cysts show MRI signal characteristics similar to cerebrospinal fluid (CSF).

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging Sciences, University of Rochester Medical Center School of Medicine and Dentistry, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA, adam_fang@urmc.rochester.edu.

ABSTRACT

Objectives: Pineal lesions can present as a heterogeneous collection of benign and malignant disease conditions. Pineal lesions include germ cell tumours, neoplasms arising from the pineal parenchyma, as well as other pineal region masses.

Methods: A variety of cases of pineal lesions are presented. The important clinical features and typical imaging findings of each pineal lesion are described with emphasis on their morphological appearance and signal intensity characteristics on magnetic resonance imaging (MRI).

Conclusion: Knowledge of the imaging characteristics and clinical features of varying pineal lesions can assist in narrowing the differential diagnosis for more accurate and rational therapeutic planning.

Teaching points: • Pineal parenchymal tumours show an "explosion" of normal pineal calcifications towards the periphery. • Pineoblastomas often have restricted diffusion, with apparent diffusion coefficient (ADC) values lower than germinomas. • Pineal teratomas and pineal lipomas display fat signal characteristics and fat saturation on MRI. • Pineal lesions in patients with known malignancy should raise suspicion of metastatic involvement. • Pineal cysts and arachnoid cysts show MRI signal characteristics similar to cerebrospinal fluid (CSF).

No MeSH data available.


Related in: MedlinePlus