Serial Follow-Up MRI of Indeterminate Cystic Lesions of the Pineal Region: Experience at a Rural Tertiary Care Referral Center
July 21st, 2009 Posted by: admin
OBJECTIVE. The purpose of this study was to retrospectively assess
the outcomes of temporal MRI follow-up of indeterminate cystic lesions of the
pineal region.
MATERIALS AND METHODS. Cases of indeterminate pineal lesions were
identified by a computerized search of radiology reports at our institution
from 1998 to 2007. Twenty-six indeterminate pineal lesions, one each in 26
patients (six males and 20 females), were followed in the current study. Cases
were included in the study if the radiology report detailed an incidentally
noted but indeterminate or worrisome cystic lesion of the pineal region and if
temporal follow-up MRI was recommended by the interpreting neuroradiologist.
For a case to be included in our data set, a follow-up MRI study must have
been obtained at least 6 months after the initial study.
RESULTS. Follow-up imaging ranged from 7 months to 8 years. Lesions
ranged in description and appearance from “probable benign cyst”
with typical cystic imaging features to “pineal mass” with
features of solid enhancement. We found that, within the limitations of the
technique, there were no significant changes in the size or character of any
indeterminate pineal region lesion followed at our institution over the time
interval of 1998-2007.
CONCLUSION. In our study, all pineal lesions found incidentally and
for which follow-up imaging had been recommended were stable over time. These
data suggest that neoplastic lesions of the pineal region either are too rare
or grow too slowly to be identified by traditional temporal imaging follow-up.
With increasing interest in optimal allocation of health care resources, our
findings suggest that incidentally identified pineal region cystic lesions,
both typical and atypical, can be followed clinically.
