title: MRI-based assessment of the pineal gland in a large population of children aged 0-5 years and comparison with pineoblastoma: part II, the cystic gland.
abstract: BACKGROUND
  Pineal cysts are a common incidental finding on brain MRI with resulting difficulties in differentiation between normal glands and pineal pathologies. The aim of this study was to assess the size and morphology of the cystic pineal gland in children (0-5 years) and compare the findings with published pineoblastoma cases.
  
  
  METHODS
  In this retrospective multicenter study, 257 MR examinations (232 children, 0-5 years) were evaluated regarding pineal gland size (width, height, planimetric area, maximal cyst(s) size) and morphology. We performed linear regression analysis with 99 % prediction intervals of gland size versus age for the size parameters. Results were compared with a recent meta-analysis of pineoblastoma by de Jong et al.
  
  
  RESULTS
  Follow-up was available in 25 children showing stable cystic findings in 48 %, cyst size increase in 36 %, and decrease in 16 %. Linear regression analysis gave 99 % upper prediction bounds of 10.8 mm, 10.9 mm, 7.7 mm and 66.9 mm(2), respectively, for cyst size, width, height, and area. The slopes (size increase per month) of each parameter were 0.030, 0.046, 0.021, and 0.25, respectively. Most of the pineoblastomas showed a size larger than the 99 % upper prediction margin, but with considerable overlap between the groups.
  
  
  CONCLUSIONS
  We presented age-adapted normal values for size and morphology of the cystic pineal gland in children aged 0 to 5 years. Analysis of size is helpful in discriminating normal glands from cystic pineal pathologies such as pineoblastoma. We also presented guidelines for the approach of a solid or cystic pineal gland in hereditary retinoblastoma patients.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Selma
authors.initials: S
authors.lastname: Sirin
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007MB, Amsterdam, The Netherlands. mc.dejong@vumc.nl.
authors.forename: Marcus C
authors.initials: MC
authors.lastname: de Jong
authors.affiliation: Unit of Diagnostic and Therapeutic Neuroradiology, Department of Neurosciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Galluzzi
authors.affiliation: Department of Radiology, University Hospital, Lausanne, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Maeder
authors.affiliation: Department of Radiology, Institut Curie, Paris, France.
authors.forename: Hervé J
authors.initials: HJ
authors.lastname: Brisse
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007MB, Amsterdam, The Netherlands.
authors.forename: Jonas A
authors.initials: JA
authors.lastname: Castelijns
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007MB, Amsterdam, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: de Graaf
authors.affiliation: Unit of Diagnostic and Therapeutic Neuroradiology, Department of Neurosciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
authors.forename: Sophia L
authors.initials: SL
authors.lastname: Goericke
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D020863:Central Nervous System Cysts / Q000000981:diagnostic imaging* / Q000473:pathology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005060:Europe; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010870:Pineal Gland / Q000000981:diagnostic imaging* / Q000473:pathology; D010871:Pinealoma / Q000000981:diagnostic imaging* / Q000473:pathology; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Gland size; Pediatric; Pineal gland; Pineoblastoma; Retinoblastoma