Friday, July 2, 2010

T1 Hyperintense Pineal Tumour

Masses in the pineal region that may demonstrate intrinsic T1 hyperintensity can be following and can be excluded with routine MR imaging techniques. For example, a fat-saturated T1-weighted sequence may exclude a teratoma, dermoid, or lipoma as in our case. A partially thrombosed aneurysm or venous malformation with subacute blood products can be excluded with MR or CT angiography and absence of pulsation artifacts. A hemorrhagic metastasis from a renal, thyroid, or melanoma primary may be excluded by the lack of susceptibility effects on gradient-echo sequences. Melanotic melanomas will also demonstrate susceptibility effects. Also note intrinsic T1 hyperintensity may be a characteristic imaging appearance for a Papillary tumour of the pineal region. In the imaging absence of fat, hemorrhage, melanin, or calcification in a mass of the posterior commissure or pineal region, the diagnosis of a PTPR may be suggested.  This is 50 year old female with headache. Differential of papillary tumour or malignant melanoma was suggested.


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