Cystic transformation of the pineal gland (radiation anatomy and epiphysis cerebri structural variants): a prospective study

Abstract

INTRODUCTION: Pineal cysts are a common finding on brain MRI, but their which remains unclear. A theory has been put forward that non-occlusive cysts can compress the deep cerebral veins, leading to intracranial hypertension.OBJECTIVE: Тo study the variant MRI appearance of the pineal gland.MATERIALS AND METHODS: 48 volunteers underwent an MRI examination using a 1.5 T Toshiba Exelart Vantage device to assess the presence of MRI signs of central venous hypertension, taking into account the morphological variants of the pineal gland structure, and a category was assigned based on the calculated tectum-splenium-cyst ratio and thalamic coefficient. The mean age of men was 41.27±4.63, of women — 31.5±2.58 years. The study participants were divided into three groups: the 1st group — no pineal cyst, the 2nd group — pineal cyst less than 10 mm, the 3rd group —a cyst larger than 10 mm.RESULTS: Based on the obtained tectum-splenium-cyst ratios and the ADC coefficient, it was found that in the volunteer group with cysts larger than 10 mm, 8 out of 15 people were at increased risk of developing central venous hypertension (categories 3 and 4). Category 4 patients had the narrowest aqueduct (1.1–1.2 mm). In the 2nd group, in persons with a pineal cyst less than 10 mm, there were no signs of aqueductal stenosis or tectal plate compression. In the 3rd group, in persons without a pineal cyst, there were also no signs of aqueductal stenosis or tectal plate compression, however, category 3 was assigned to 8 volunteers, which may be due to other causes of venous outflow impairment.CONCLUSION: A large pineal cysts occur in younger patients, and in the presence of aqueductal narrowing and an increased risk of venous hypertension may cause clinical manifestations such as headaches, dizziness, and sleep disturbances. When patients present with relevant complaints, categorization based on DWI and SSFP is an additional criterion that reflects the degree of impact of the pineal cyst on adjacent structures.