Pineal gland cyst evaluated by transcranial sonography

Abstract

Transcranial sonography (TCS) has never been used in the evaluation of morphology of pineal gland. The aim of the study was to assess the possibility of TCS to distinguish normal from cystic pineal gland and to correlate its size with magnetic resonance imaging (MRI) at the first examination and during follow-up. Sixty patients with previously made MRI of the brain were evaluated by two independent observers using TCS, blinded to the results of the MRI. Inappropriate bone window limited TCS examination in seven patients. All 14 pineal gland cysts (PGC) seen on MRI were detected by both observers using TCS. Control group consisted of 39 healthy examinees. No statistically significant difference has been found between: PGC size measured by first and second observer by TCS (P = 0.425), PGC size measured by TCS and MRI (first observer, P = 0.353; second observer, P = 0.425), size of the pineal gland measured by TCS and MRI in control group (first observer, P = 0.497; second observer, P = 0.370) or interobserver variability in control group (P = 0.373). The MRI and TCS follow-up of ten patients after six months did not show any difference in size of PGC. TCS can be used as a method in detection, measurement and follow-up of PGC.

Brain topography on adult ultrasound images: Techniques, interpretation, and image library

“…The following structures were reproducibly discernible on B‐mode imaging in our study: Midbrain: easily visible structure located in the center of the cranium in the shape of a butterfly with wings representing the peduncles (Figures 3, 6, and 9; Video S3). We found 15 publications that describe midbrain or brainstem landmarks 3–19 Basal cisterns: hyperechoic signals in cisterns around the midbrain with signal intensity lower than bone when compared to opposite skull 19,20 (Figures 3 and 9).…”

“…Cerebral aqueduct: a dot‐like hyperechoic structure within the posterior end of the midbrain (Figures 9 and 10). Calcified choroid plexus: visible as three spaced hyperechoic signals with the appearance of “a spaceship” in the middle of the cranium 9 (Figure 11; Video S2). Lateral ventricles: two anechoic structures visible in the temporal or frontal lobes surrounded by hyperechoic margins 14,17,21,23–26 .…”

“…Third ventricle: often visible as two parallel lines sometimes pulsating in the vicinity of midbrain with probe pointed superiorly and anteriorly (Figure 12; Video S6). Eight other publications have described the appearance of third ventricle on cranial ultrasound as an anechoic area surrounded by two hyperechoic margins observed by tilting the probe 10° up after identification of midbrain 3,7,9,10,14,17,21,28 Pineal gland: a small dot‐like structure in the center of the brain posterior to the midbrain.…”

“…We found 15 publications that describe midbrain or brainstem landmarks. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] b. Basal cisterns: hyperechoic signals in cisterns around the midbrain with signal intensity lower than bone when compared to opposite skull 19,20 (Figures 3 and 9). g. Lateral ventricles: two anechoic structures visible in the temporal or frontal lobes surrounded by hyperechoic margins.…”

“…c. Falx cerebri: hyperechoic line in the middle of the cranium toward the frontal bone with probe pointed superiorly9 (Figures4, 5, and 9). d. Thalami: visible as two bean-like structures on moving the probe superior to the midbrain7,17,21,22 (Figures5 and 12; Video S6).…”