Evaluation of pineal cysts with magnetic resonance imaging

Table 1 Magnetic resonance imaging examination parameters before 2017

Parameter	T1 (SPGR)	T2 (SE)	FLAIR	DWI	Ax SPGR + C	Sag T1 SE + C	Ax T1 FS + C
TR (repetition time) (ms)	6.36	5700	8002	8000	6.36	440	620
TE (echo time) (ms)	2.23	134	80.9	104	2.23	12	20
Field of view (mm)	260	250	220	250	260	250	250
Slice thickness (mm)	4	5	5.5	5	4	5.5	5.5
Slice gap (mm)	2	6.5	6.5	6.5	2	6.5	7
NEX (No. of excitations)	1	1.5	1	2	1	1	1
TI (time inversion) ms	450		2000		450
Machine	1.5 T GE Signa Excite HD (8 channel head coil)

SPGR: Spoiled gradient recalled acquisition in steady state; SE: Spin echo; FLAIR: Fluid-attenuated inversion recovery; DWI: Diffusion weighted imaging; Ax: Axial plane; Sag: Sagittal plane; + C: Contrast-enhanced; FS: Fat saturation.

Table 2 Magnetic resonance imaging examination parameters after 2017

Parameter	T1 (BRAVO)	T2 (SE)	FLAIR FS	DWI	T1 (BRAVO) +C	Cor T1 (SE) + C	Ax T1 FS + C
TR (repetition time) (ms)	9.25	6282	10000	6992	9.25	3509	2744
TE (echo time) (ms)	3.58	124	91.7	84.4	3.58	17.8	17.5
Field of view (mm)	256	220	240	270	256	240	256
Slice thickness (mm)	1	5.5	5.5	5	1	5.5	5.5
Slice gap (mm)	0	7	7	5.5	0	7	7
NEX (No. of excitations)	1	2	1	2	1	1	1
TI (time inversion) (ms)	420		2688		420	1146	922
Machine	1.5 T GE Signa Explorer SV 25 (16 channel neurovascular-head coil)

BRAVO: Brain volume imaging; SE: Spin echo; FLAIR: Fluid-attenuated inversion recovery; FS: Fat saturation; DWI: Diffusion weighted imaging; + C: Contrast-enhanced; Cor: Coronal plane; Ax: Axial plane.

Table 3 Demographic and clinical characteristics of patients with pineal cyst

Demographic and clinical characteristics	n (%)
No. of patients	56
Pineal cyst prevalence	0.58%
Median age (mean ± SD, range) (yr)	31.26 ± 12.73 (5–61)
Sex
Female	44 (78.57)
Male	12 (21.43)
MRI request reasons
Headache	42 (75)
Epilepsy	7 (12.50)
Cerebrovascular disease	4 (7.14)
Vertigo	1 (1.78)
Encephalitis	1 (1.78)
Hand tremor	1 (1.78)

MRI: Magnetic resonance imaging.

Table 4 Magnetic resonance imaging features of pineal cysts

MRI features of pineal cysts	n (%)
Cyst type
Typical	35 (62.50)
Atypical	21 (37.50)
Two or more septation-loculation	18 (32.14)
Contour lobularity	11 (19.64)
Cyst contrast-enhancement	21
Peripheral rim enhancement	15 (71.42)
Peripheral rim and septal enhancement	3 (14.28)
Partial rim enhancement	2 (9.52)
Dense heterogeneous enhancement	1 (4.76)
Cyst intensity relative to CSF on T2 weighted images
Isointense	55 (98.21)
Hyperintense	1 (1.79)
Cyst intensity relative to CSF on T1 weighted images
Isointense	53 (94.64)
Hyperintense	3 (5.36)
Cyst intensity relative to CSF on FLAIR images
Isointense	6 (10.71)
Hyperintense	50 (89.29)
Diffusion restriction	0

MRI: Magnetic resonance imaging; CSF: Cerebrospinal fluid; FLAIR: Fluid-attenuated inversion recovery.

Table 5 lInitial dimensions and volumes and subsequent changes of pineal cysts

Pineal cyst dimensions and volume	Value (range)
Minimal-maximal linear dimension	5.0-19.70 mm
All plane mean dimension (AP, ML, CC)	10.07 ± 2.93 mm
Cyst volume (mean ± SD, range)	0.62 ± 0.54 (0.11-3.35) cm³
Cyst dimension (mean ± SD, range) (mm)
Anteroposterior (AP)	11.18 ± 3.03 (6.50-19.00)
Mediolateral (ML)	10.41 ± 2.72 (5.80-19.70)
Craniocaudal (CC)	8.63 ± 2.47 (5.0-18.30)
Changes in dimensions during follow-up period (mean ± SD, range) (mm)
Anteroposterior (AP)	-0.08 ± 0.53 (-1.60-0.7)
Mediolateral (ML)	-0.22 ± 0.87 (-3-0.8)
Craniocaudal (CC)	0.16 ± 0.56 (-0.70-1.40)