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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

Teratoma in a 56-year-old man with worsening confusion and ataxia. The pineal lesion (arrow) is hyperintense relative to brain with foci of very low signal on sagittal T1-weighted image (a) and mixed low, intermediate and high signal on axial T2-weighted image (b). Internal foci and peripheral rim of low signal on T1-weighted and T2-weighted images correspond to calcifications seen on axial CT image (c)
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Fig7: Teratoma in a 56-year-old man with worsening confusion and ataxia. The pineal lesion (arrow) is hyperintense relative to brain with foci of very low signal on sagittal T1-weighted image (a) and mixed low, intermediate and high signal on axial T2-weighted image (b). Internal foci and peripheral rim of low signal on T1-weighted and T2-weighted images correspond to calcifications seen on axial CT image (c)

Mentions: MRI findings demonstrate a multi-loculated and lobulated lesion with mixed signal, including areas of high signal intensity on T1-weighted images due to the presence of fat or lipid components, and areas of low signal from calcification (Fig. 7). T2-weighted images often have a low to intermediate signal soft tissue component (Fig. 7). Post-contrast images can show enhancement of the soft tissue component (Fig. 7). Teratomas with malignant transformation have a more homogeneous imaging appearance with fewer cysts and calcifications [9].Fig. 7


Magnetic resonance imaging of pineal region tumours.

Fang AS, Meyers SP - Insights Imaging (2013)

Teratoma in a 56-year-old man with worsening confusion and ataxia. The pineal lesion (arrow) is hyperintense relative to brain with foci of very low signal on sagittal T1-weighted image (a) and mixed low, intermediate and high signal on axial T2-weighted image (b). Internal foci and peripheral rim of low signal on T1-weighted and T2-weighted images correspond to calcifications seen on axial CT image (c)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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Fig7: Teratoma in a 56-year-old man with worsening confusion and ataxia. The pineal lesion (arrow) is hyperintense relative to brain with foci of very low signal on sagittal T1-weighted image (a) and mixed low, intermediate and high signal on axial T2-weighted image (b). Internal foci and peripheral rim of low signal on T1-weighted and T2-weighted images correspond to calcifications seen on axial CT image (c)
Mentions: MRI findings demonstrate a multi-loculated and lobulated lesion with mixed signal, including areas of high signal intensity on T1-weighted images due to the presence of fat or lipid components, and areas of low signal from calcification (Fig. 7). T2-weighted images often have a low to intermediate signal soft tissue component (Fig. 7). Post-contrast images can show enhancement of the soft tissue component (Fig. 7). Teratomas with malignant transformation have a more homogeneous imaging appearance with fewer cysts and calcifications [9].Fig. 7

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