Cauley Keith A, Linnell Grant J, Braff Steven P, Filippi Christopher G
Department of Radiology, Division of Neuroradiology, Fletcher Allen Health Care, Medical Center Campus, Burlington, VT, USA.
AJR Am J Roentgenol. 2009 Aug;193(2):533-7. doi: 10.2214/AJR.08.1906.
The purpose of this study was to retrospectively assess the outcomes of temporal MRI follow-up of indeterminate cystic lesions of the pineal region.
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.
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.
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.
本研究旨在回顾性评估松果体区不确定囊性病变的颞部MRI随访结果。
通过对我院1998年至2007年放射学报告进行计算机检索，确定松果体区不确定病变的病例。本研究对26例松果体区不确定病变进行了随访，26例患者各有1个病变（6例男性，20例女性）。如果放射学报告详细描述了偶然发现但不确定或令人担忧的松果体区囊性病变，且解读神经放射科医生建议进行颞部随访MRI，则该病例纳入本研究。要纳入我们的数据集，随访MRI研究必须在初始研究后至少6个月进行。
随访成像时间为7个月至8年。病变的描述和外观范围从具有典型囊性成像特征的“可能良性囊肿”到具有实性强化特征的“松果体肿块”。我们发现，在技术的限制范围内，1998 - 2007年期间我院随访的任何松果体区不确定病变的大小或特征均无显著变化。
在我们的研究中，所有偶然发现且建议进行随访成像的松果体病变随时间推移均保持稳定。这些数据表明，松果体区的肿瘤性病变要么过于罕见，要么生长过于缓慢，无法通过传统的颞部成像随访识别。随着对医疗资源优化分配的兴趣增加，我们的研究结果表明，偶然发现的松果体区囊性病变，无论是典型还是非典型的，均可进行临床随访。
