Incidental Pineal Cysts in a Prospectively Ascertained Normal Cohort

High Prevalence of Pineal Cysts in Healthy Adults Demonstrated by High-Resolution, Noncontrast Brain MR Imaging

“…17 Thirteen percent of subjects in this study demonstrated cystic changes in the pineal gland. A possible explanation for the difference between the prevalence of the pineal cysts demonstrated in our study and that in other MR imaging studies is that we used high-resolution MR imaging with a 1.0 mm resolution on the 3D T1WI and an in-plane resolution of 1.0 mm with an axial resolution of 2.0 mm on the T2WI.…”

“…An in-plane resolution of 1.0 mm and an axial resolution of 3.0 mm were used in the prior MR imaging study of healthy volunteers. 17 Because the smallest reported pineal cyst was 2.0 mm, 8 we classified MR imaging signal intensity changes compatible with pineal cysts but less than 2.0 mm in diameter as being pineal cystic changes; they were not considered pineal cysts. The high prevalence rate of pineal cysts and cystic changes demonstrated in this study is consistent with prior autopsy studies that showed macroscopic (measuring up to 0.5 ϫ 0.3 ϫ 0.2 cm) and microscopic cysts in 21.8% and 17.9% of patients, respectively, who died from various diseases in 168 consecutive cases.…”

“…In another study, Golzarian et al 6 followed 12 subjects with pineal cysts; the cysts did not change in size throughout the 1-year follow-up. Finally, Bodensteiner et al 17 reported 2 cases of pineal cysts in 27 healthy volunteers; the cysts did not change in size throughout the follow-up period of 6 months.…”

“…One study, conducted among healthy volunteers aged between 22 and 40 years (13 men and 14 women) and using the conventional spin-echo T1-weighted sequence, reported the prevalence of benign pineal cysts to be 7.4%. 17 The differential diagnosis of simple pineal cysts and cystic tumors, such as astrocytoma, pineocytoma, and pineoblastoma, is crucial for clinical management. 7,18 Although there are no reliable diagnostic criteria for the differential diagnosis of such entities, most authors describe the benign pineal cyst as being well circumscribed and usually elliptical, with a slight hyperintensity or a similar signal intensity relative to the CSF on both the T1-weighted image (T1WI) and the T2-weighted image (T2WI).…”

Prevalence and natural history of pineal cysts in adults

“…6,19,52,59 There have been several prior attempts to analyze the prevalence of pineal cysts in patients undergoing intracranial imaging, with estimates ranging from 1.0% to 4.3%. 3,7,15,22,[33][34][35]40,51,61 In the largest series of pineal cysts in adults prior to our current study, Sawamura et al 59 evaluated MR images from 6023 patients and found 79 pineal cysts (prevalence of 1.3%). In an age-specific prevalence analysis, these authors found a decrease in the prevalence of pineal cysts on imaging in adults.…”