Nevin AYDIN, Suzan ŞAYLISOY, Bülent YILDIZ

Pineal Metastazların Manyetik Rezonans Görüntüleme Bulguları

Pineal bez metastazları oldukça nadirdir. Çalışmamızın amacı, pineal bez metastazlarının manyetik rezonans görüntüleme bulgularını değerlendirmektir. Bu çalışmada Eylül 2010 ile Aralık 2019 tarihleri arasında hastane/ radyoloji arşivindeki beyin manyetik rezonans görüntülemelerinin raporları retrospektif olarak tarandı. Olgular belirlendikten sonra, hastaların cinsiyet, yaş, tanı, sağkalım süresi gibi özellikleri ve boyut (en büyük kesit çap), T1 ağırlıklı, T2 ağırlıklı sinyaller, kontrast tutulumu, ek beyin metastatik tutulum alanları gibi özellikler değerlendirildi. Araştırmamızda pineal metastazlı 7 hasta tespit edildi. Altta yatan maligniteler akciğer (N 2), meme (N 2), prostat kanseri (N 1), nöroblastom (N 1), non-Hodgkin lenfoma (N 1) idi. Pineal metastaz saptandıktan sonra ortalama yaşam süresi 3.14 aydı. Lezyonların boyutları 0.8 ile 1.8 cm arasında değişiyordu. Altı tümör, hem T1 ağırlıklı hem de T2 ağırlıklı olarak gri cevhere göre izointens idi. Biri T1 ağırlıklı ve T2 ağırlıklı görüntülerde heterojen sinyal intensitesi gösterdi. 7 tümörden 6'sı homojen solid kontrastlanma gösterirken, bir tümör nekroza bağlı heterojen kontrastlanma gösterdi. İki hastada leptomeningeal, bir hastada hipofiz sapı, bir hastada parankim, bir hastada kalvaryum-dural metastaz vardı. Kalan 3 hastada ise beyinde eşlik eden metastaz izlenmedi. Bilinen malignitesi olan hastalarda pineal lezyonların varlığı metastatik tutulum şüphesini artırmalıdır.

Anahtar Kelimeler:

pineal bez, metastaz, manyetik rezonans görüntüleme, pineal, pineal görüntüleme, pineal lezyonlar

Magnetic Resonance Imaging Findings of Pineal Metastasis

The pineal gland metastatic disease is relatively uncommon. Our research’s objective was to assess pineal gland metastasis findings from magnetic resonance imaging (MRI). We queried the radiology reports of brain MRI examinations performed between September 2010 and December 2019. After identifying cases, patient characteristics including sex, age, diagnosis, survival time, and MRI features including size (largest cross-sectional diameter), T1- Weighted Image (WI) signal, T2-WI signal, contrast enhancement, and additional brain metastatic involvement area were evaluated. Our investigation identified 7 patients with pineal gland metastasis. Underlying malignancies were lung (N 2), breast (N 2), prostate cancer (N 1), neuroblastoma (N 1), and non-Hodgkin lymphoma (N 1). The average survival period after the detection of the pineal gland metastasis is 3.14 ± 3.93 months. The lesions ranged in size from 0.8 to 1.8 cm (mean 1.18±0.38 cm). Six tumors were isointense to gray matter both on T1-WI and T2-WI. One showed heterogeneous signal intensities on T1-WI and T2-WI. 6 out of 7 tumors showed homogenous solid enhancement while one tumor showed heterogeneous enhancement due to necrosis. Two patients had leptomeningeal, one patient had pituitary stalk, one patient had parenchyma, and one patient had calvarium-dural metastases. In the remaining 3 patients, no accompanying metastases were observed in brain. The presence of pineal gland lesions in patients with known malignancy should increase suspicion of metastatic involvement.

Keywords:

pineal gland, metastatis, magnetic resonance imaging, pineal, pineal imaging, pineal lesions,

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