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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

Primitive neuroectodermal tumour (PNET) involving the pineal gland in a 3-year-old boy. Well-circumscribed, tumour arising from the pineal gland (arrow), which has mostly intermediate signal as well as high signal foci on sagittal T1-weighted image (a) and intermediate, low and high signal on axial T2-weighted image (b). The pineal tumour demonstrates heterogeneous contrast enhancement on sagittal T1-weighted image (c). The tumour causes obstructive hydrocephalus by exerting localised mass effect and compression of the quadrigeminal plate, cerebral aqueduct and third ventricle
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Fig14: Primitive neuroectodermal tumour (PNET) involving the pineal gland in a 3-year-old boy. Well-circumscribed, tumour arising from the pineal gland (arrow), which has mostly intermediate signal as well as high signal foci on sagittal T1-weighted image (a) and intermediate, low and high signal on axial T2-weighted image (b). The pineal tumour demonstrates heterogeneous contrast enhancement on sagittal T1-weighted image (c). The tumour causes obstructive hydrocephalus by exerting localised mass effect and compression of the quadrigeminal plate, cerebral aqueduct and third ventricle

Mentions: On MRI, PNETs demonstrate low signal relative to cortical grey matter on T1-weighted images and can have high signal on T2-weighted images from cystic or necrotic areas. These tumours can present with areas of restricted diffusion [36]. Haemorrhage may also occur and can appear as areas with low signal on T2-weighted images. These lesions often show heterogeneous enhancement with contrast (Fig. 14).Fig. 14


Magnetic resonance imaging of pineal region tumours.

Fang AS, Meyers SP - Insights Imaging (2013)

Primitive neuroectodermal tumour (PNET) involving the pineal gland in a 3-year-old boy. Well-circumscribed, tumour arising from the pineal gland (arrow), which has mostly intermediate signal as well as high signal foci on sagittal T1-weighted image (a) and intermediate, low and high signal on axial T2-weighted image (b). The pineal tumour demonstrates heterogeneous contrast enhancement on sagittal T1-weighted image (c). The tumour causes obstructive hydrocephalus by exerting localised mass effect and compression of the quadrigeminal plate, cerebral aqueduct and third ventricle
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3675249&req=5

Fig14: Primitive neuroectodermal tumour (PNET) involving the pineal gland in a 3-year-old boy. Well-circumscribed, tumour arising from the pineal gland (arrow), which has mostly intermediate signal as well as high signal foci on sagittal T1-weighted image (a) and intermediate, low and high signal on axial T2-weighted image (b). The pineal tumour demonstrates heterogeneous contrast enhancement on sagittal T1-weighted image (c). The tumour causes obstructive hydrocephalus by exerting localised mass effect and compression of the quadrigeminal plate, cerebral aqueduct and third ventricle
Mentions: On MRI, PNETs demonstrate low signal relative to cortical grey matter on T1-weighted images and can have high signal on T2-weighted images from cystic or necrotic areas. These tumours can present with areas of restricted diffusion [36]. Haemorrhage may also occur and can appear as areas with low signal on T2-weighted images. These lesions often show heterogeneous enhancement with contrast (Fig. 14).Fig. 14

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