Radiological approach for pineal region masses

ABSTRACT

Thirty-two pineal and related tumors were diagnosed by computed tomography [CT] and magnetic resonance imaging [MRI]. Pineal region tumors were classified as germ-cell tumors, glial tumors, pineal parenchymal tumors and cysts. They demonstrated different MR signal characteristics on pre-contrast scans and nodular or ring type enhancement with occasional central lucencies, except for benign cysts which have not shown any enhancement. MR images were useful in defining the relationship of the tumor to the posterior third ventricle, Sylvian aqueduct, vein of Galen and tentorium. Although CT can demonstrate more evident fashion displacement of the original pineal calcification as well as tumor calcifications, MR imaging demonstrates different signal characteristics in germinomas and pineoblastomas which can be a useful adjunct in the evaluation and differential diagnosis of these tumors. There were eight germinomas, four primary pineal tumors, two embryonal cell carcinomas and choriocarcinoma, five teratoma, two primitive neuroectodermal tumor, four astrocytomas, two lipomas, four meningiomas and one pineal cyst