"Imaging protocol "
"Systematic approach to interpretation "
"The pineal gland is a small (~7 mm AP diameter) structure located at the posterior-most aspect of the third ventricle below the internal cerebral veins and above and posterior to the tectum of the midbrain."
"The pattern of involvement of calcification when the pineal gland is involved by a mass can be helpful. Pineal parenchymal tumours (e.g. pineocytoma or pineoblastoma) tend to peripherally disperse calcification whereas germ cell tumours tend to engulf the calcifications. An easy way to remember this is that pineoblastomas tend to blast the calcifications apart."
"The pattern of involvement of calcification when the pineal gland is involved by a mass can be helpful. Pineal parenchymal tumours (e.g. pineocytoma or pineoblastoma) tend to peripherally disperse calcification whereas germ cell tumours tend to engulf the calcifications. An easy way to remember this is that pineoblastomas tend to blast the calcifications apart."
"Diffusion weighted imaging is also helpful as densely cellular tumours (e.g. pineoblastoma, meningioma and lymphoma) tend to demonstrate increased restricted diffusion compared to normal brain parenchyma."
Expected headings
"Imaging protocol "
"Systematic approach to interpretation "
"Location"
"Calcification"
"Solid component"
"Spread and seeding"
"Local invasion"
"CSF seeding"
"The pineal region is best imaged with MRI although CT, angiography and ultrasound (in infants) also play a role."
"Assessing these structures will determine whether a lesion is actually of the pineal gland or whether it represents extension into the pineal region of an adjacent mass (e.g. tentorial meningioma or tectal plate glioma)."
"Some pineal region masses are very well circumscribed and do not invade adjacent structures (e.g. pineal cyst, pineocytoma) whereas more aggressive masses can invade extensively into the adjacent brain and brainstem (e.g. pineoblastoma, some germ cell tumours)."