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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

Atypical teratoid/rhabdoid tumour (AT/RT) in a 10-month-old boy. Sagittal T1-weighted image (a) shows a large tumour with poorly-defined margins involving the pineal gland and midbrain (arrow), which is heterogeneous and predominately isointense to grey matter. The tumour (arrow) has intermediate to high signal on an axial T2-weighted image (b), and shows prominent contrast enhancement with irregular margins on axial T1-weighted image (c)
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Fig15: Atypical teratoid/rhabdoid tumour (AT/RT) in a 10-month-old boy. Sagittal T1-weighted image (a) shows a large tumour with poorly-defined margins involving the pineal gland and midbrain (arrow), which is heterogeneous and predominately isointense to grey matter. The tumour (arrow) has intermediate to high signal on an axial T2-weighted image (b), and shows prominent contrast enhancement with irregular margins on axial T1-weighted image (c)

Mentions: On MRI, AT/RTs often have heterogeneous intermediate signal on T1-weighted and T2-weighted images as well as areas of low and high signal from haemorrhagic, cystic and/or necrotic zones. Restricted diffusion is also commonly seen involving these tumours. On post-contrast images, there is variable enhancement (Fig. 15). In a quarter of patients with AT/RT, leptomeningeal dissemination is found at the time of presentation [37, 39, 40].Fig. 15


Magnetic resonance imaging of pineal region tumours.

Fang AS, Meyers SP - Insights Imaging (2013)

Atypical teratoid/rhabdoid tumour (AT/RT) in a 10-month-old boy. Sagittal T1-weighted image (a) shows a large tumour with poorly-defined margins involving the pineal gland and midbrain (arrow), which is heterogeneous and predominately isointense to grey matter. The tumour (arrow) has intermediate to high signal on an axial T2-weighted image (b), and shows prominent contrast enhancement with irregular margins on axial T1-weighted image (c)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3675249&req=5

Fig15: Atypical teratoid/rhabdoid tumour (AT/RT) in a 10-month-old boy. Sagittal T1-weighted image (a) shows a large tumour with poorly-defined margins involving the pineal gland and midbrain (arrow), which is heterogeneous and predominately isointense to grey matter. The tumour (arrow) has intermediate to high signal on an axial T2-weighted image (b), and shows prominent contrast enhancement with irregular margins on axial T1-weighted image (c)
Mentions: On MRI, AT/RTs often have heterogeneous intermediate signal on T1-weighted and T2-weighted images as well as areas of low and high signal from haemorrhagic, cystic and/or necrotic zones. Restricted diffusion is also commonly seen involving these tumours. On post-contrast images, there is variable enhancement (Fig. 15). In a quarter of patients with AT/RT, leptomeningeal dissemination is found at the time of presentation [37, 39, 40].Fig. 15

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