MR imaging of pineal tumors. 1990

R D Tien, and A J Barkovich, and M S Edwards
Department of Radiology, University of California, San Francisco 94143-0628.

MR images of pineal region tumors were analyzed in 26 patients with histologically proved tumors: seven germ-cell tumors, six astrocytomas, five teratomas, three pineoblastomas, two meningiomas, one dermoid, one epidermoid, and one metastasis. In an attempt to identify specific MR characteristics of these lesions, Gd-DTPA was administered to six patients. CSF and blood serum were assayed for alpha-fetoprotein (AFP) and human chorionic gonadotropin-beta subunit (HCG-beta) in 18 patients. MR findings were correlated with age, sex, the presence of biochemical tumor markers, and surgical outcome. We found that the most important factors in the determination of tumor type were the patient's age and the tumor markers. Increased levels of both HCG-beta and AFP were specific for patients with malignant teratomas and undifferentiated germ-cell tumors. HCG-beta alone was elevated in the patient with choriocarcinoma; only AFP was elevated in the patient with an endodermal sinus tumor. Tumor markers were not present in other patients in this series. The tumor size and the presence of fat were also helpful in determining tumor type. Hemorrhage was rare, seen only in the patient with a choriocarcinoma. Gd-DTPA did not enhance diagnostic specificity but aided in the detection of tumor seeding through CSF. We conclude that, although MR is sensitive in the detection of pineal region tumors and provides superb anatomic detail, MR signal characteristics are usually nonspecific. Correlation with the patient's age and the tumor markers significantly improves diagnostic accuracy.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009373 Neoplasms, Germ Cell and Embryonal Neoplasms composed of primordial GERM CELLS of embryonic GONADS or of elements of the germ layers of the EMBRYO, MAMMALIAN. The concept does not refer to neoplasms located in the gonads or present in an embryo or FETUS. Germ Cell Cancer,Germ Cell Tumor,Neoplasms, Embryonal and Mixed,Cancer, Embryonal,Cancer, Embryonal and Mixed,Embryonal Neoplasms,Germ Cell Neoplasms,Germ Cell and Embryonal Neoplasms,Germ Cell and Embryonic Neoplasms,Neoplasms, Embryonal,Neoplasms, Germ Cell,Neoplasms, Germ Cell and Embryonic,Cancer, Germ Cell,Cancers, Embryonal,Cancers, Germ Cell,Embryonal Cancer,Embryonal Cancers,Embryonal Neoplasm,Germ Cell Cancers,Germ Cell Tumors,Neoplasm, Embryonal,Tumor, Germ Cell,Tumors, Germ Cell
D009380 Neoplasms, Nerve Tissue Neoplasms composed of nerve tissue. This concept does not refer to neoplasms located in the nervous system or its component nerves. Neoplasms, Nervous Tissue,Nerve Tissue Neoplasms,Nervous Tissue Neoplasms,Neoplasm, Nerve Tissue,Neoplasm, Nervous Tissue,Nerve Tissue Neoplasm,Nervous Tissue Neoplasm
D010870 Pineal Gland A light-sensitive neuroendocrine organ attached to the roof of the THIRD VENTRICLE of the brain. The pineal gland secretes MELATONIN, other BIOGENIC AMINES and NEUROPEPTIDES. Epiphysis Cerebri,Pineal Body,Corpus Pineale,Gland, Pineal,Pineal Bodies,Pineal Glands
D010871 Pinealoma Neoplasms which originate from pineal parenchymal cells that tend to enlarge the gland and be locally invasive. The two major forms are pineocytoma and the more malignant pineoblastoma. Pineocytomas have moderate cellularity and tend to form rosette patterns. Pineoblastomas are highly cellular tumors containing small, poorly differentiated cells. These tumors occasionally seed the neuroaxis or cause obstructive HYDROCEPHALUS or Parinaud's syndrome. GERMINOMA; CARCINOMA, EMBRYONAL; GLIOMA; and other neoplasms may arise in the pineal region with germinoma being the most common pineal region tumor. (From DeVita et al., Cancer: Principles and Practice of Oncology, 5th ed, p2064; Adams et al., Principles of Neurology, 6th ed, p670) Neoplasms, Pineal,Pineal Neoplasms,Pinealocytoma,Pineoblastoma,Pineocytoma,Mixed Pineocytoma-Pineoblastoma,Pineal Gland Tumor,Pineal Parenchymal Tumors,Pineal Tumors,Mixed Pineocytoma Pineoblastoma,Mixed Pineocytoma-Pineoblastomas,Neoplasm, Pineal,Pineal Gland Tumors,Pineal Neoplasm,Pineal Parenchymal Tumor,Pineal Tumor,Pinealocytomas,Pinealomas,Pineoblastomas,Pineocytoma-Pineoblastoma, Mixed,Pineocytoma-Pineoblastomas, Mixed,Pineocytomas,Tumor, Pineal,Tumor, Pineal Gland,Tumor, Pineal Parenchymal,Tumors, Pineal,Tumors, Pineal Gland,Tumors, Pineal Parenchymal
D001932 Brain Neoplasms Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. Brain Cancer,Brain Metastases,Brain Tumors,Cancer of Brain,Malignant Primary Brain Tumors,Neoplasms, Intracranial,Benign Neoplasms, Brain,Brain Neoplasm, Primary,Brain Neoplasms, Benign,Brain Neoplasms, Malignant,Brain Neoplasms, Malignant, Primary,Brain Neoplasms, Primary Malignant,Brain Tumor, Primary,Brain Tumor, Recurrent,Cancer of the Brain,Intracranial Neoplasms,Malignant Neoplasms, Brain,Malignant Primary Brain Neoplasms,Neoplasms, Brain,Neoplasms, Brain, Benign,Neoplasms, Brain, Malignant,Neoplasms, Brain, Primary,Primary Brain Neoplasms,Primary Malignant Brain Neoplasms,Primary Malignant Brain Tumors,Benign Brain Neoplasm,Benign Brain Neoplasms,Benign Neoplasm, Brain,Brain Benign Neoplasm,Brain Benign Neoplasms,Brain Cancers,Brain Malignant Neoplasm,Brain Malignant Neoplasms,Brain Metastase,Brain Neoplasm,Brain Neoplasm, Benign,Brain Neoplasm, Malignant,Brain Neoplasms, Primary,Brain Tumor,Brain Tumors, Recurrent,Cancer, Brain,Intracranial Neoplasm,Malignant Brain Neoplasm,Malignant Brain Neoplasms,Malignant Neoplasm, Brain,Neoplasm, Brain,Neoplasm, Intracranial,Primary Brain Neoplasm,Primary Brain Tumor,Primary Brain Tumors,Recurrent Brain Tumor,Recurrent Brain Tumors,Tumor, Brain
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children

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