MRI and H-1-MRS on diagnosis of pineal region tumors

作者：Tong Tong^*; Yao Zhenwei; Feng Xiaoyuan

来源：Clinical Imaging, 2012, 36(6): 702-709.

DOI：10.1016/j.clinimag.2012.01.039

• Pineal body
• Magnetic resonance imaging
• Differential diagnosis
• Diffusion-weighted imaging
• Magnetic resonance spectroscopy

Purpose: The purpose was to analyze characteristic magnetic resonance (MR) imaging of pineal region tumors and to explore the value of diffusion-weighted imaging (DWI) and H-1-MR spectroscopy (H-1-MRS) in differential diagnosis among four common solid diseases: germinoma, teratoma, pineoblastoma, and glioma. Methods: Thirty-three patients with pineal region tumors proven by pathology were prospectively studied. All of them underwent MRI SE-TIWI, FSE-T2WI, fluid-attenuated inversion recovery (FLAIR), and postcontrasted MR scan. Minimum apparent diffusion coefficient (ADC) value, and maximum MRS choline/N-acetyl-aspartate (Cho/NAA) and lipid/creatine (Lip/Cr) metabolic peak-height ratios were quantified within each lesion. Results: Most pineal region diseases have their typical morphology, signal intensity, and enhancement style. ADC values were lower in germinoma [(6.98 +/- 0.35)*10(-4)] and pineoblastoma [(9.14 +/- 0.79)*10(-4)] than in teratoma [(2.80 +/- 0.18)*10(-3)] and pineal glioma [(1.63 +/- 0.66)*10(-3)] (P<.05). Cho/NAA ratios were higher in germinoma (2.09 +/- 0.39), pineoblastoma (4.70 +/- 0.82), and pineal glioma (3.54 +/- 0.38) than in teratoma (1.52 +/- 0.91) (P<.05). Lip/Cr ratios were lower in germinoma (2.52 +/- 0.41) than in teratoma (8.47 +/- 1.16) (P<.05). Conclusions: Changes in morphologic features, signal intensity, and enhancement style are the most helpful variables for the differential diagnosis of pineal region tumors. To some extent, DWI and H-1-MRS imaging enable distinction among them.

• 出版日期2012-12
• 单位复旦大学