Author: Vinit Amin

NECT CECT MRI - T1 MRI - T2 MRI - FLAIR MRI - Diffusion MRI - T1 post-contrast
Normal Pineal Gland Frequently calcifies. Attenuation is otherwise equal to that of gray matter. Pineal lacks blood-brain barrier, enhances uniformly with contrast administration May appear isointense to gray matter. May appear isointense to gray matter. May appear isointense to gray matter. No restricted diffusion. Uniformly enhances.
Germinoma Image 1 Demonstrates intense homogenous enhancement. (No image available.) Iso- or hypointense to grey matter. Iso- or hyperintense to grey matter. Iso- or hyperintense to grey matter. High signal intensity in the lesion, a finding indicative of high cellularity. (No image available) Homogeneous enhancement.
Choriocarcinoma Frequently seen as a solitary mass with heterogeneously increased attenuation. Demonstrates moderate heterogenous enhancement. (No image available.) Isointense lesions with small foci of hyperintensity. Markedly heterogeneous with areas of both hypointense and hyperintense signal intensity. Heterogeneous enhancement, ringlike enhancement, and/or intratumoral nodular enhancement.
Teratoma Variable. May contain fat, calcification, teeth.Hemorrhage is possible. Tooth is diagnostic. May demonstrate relative homogeneous enhancement of the noncalcified solid portions of the tumor. However, the cystic region does not enhance. Heterogeneous mass that may contain varying amounts of hyperintense lipid material. Cystic regions may have higher signal than that of CSF because of proteinaceous material.     May show enhancement of the soft tissue portions of the lesion.
Yolk Sac Tumor Relatively homogeneous, low-attenuation mass that may engulf the pineal calcifications. Nonspecific homogeneous enhancement. Minimal heterogeneity. Slightly hypointense relative to gray matter. Nonspecific homogeneous hyperintensity. Nonspecific imaging features. Nonspecific imaging features. Prominent but slightly heterogeneous enhancement.
Pineoblastoma Hyperdense. Calcifications may explode toward the periphery. May hemorrhage. Usually large and lobulated. Demonstrates moderate homogeneous enhancement. (No image available) Heterogeneous with the solid portion appearing hypo- to isointense. Heterogeneous, may be hyperintense relative to gray matter. Demonstrates high signal. Hyperintensity within the lesion, a finding suggestive of high cellularity. (No image.) Heterogeneous enhancement within the mass.
Pineocytoma Hyperdense. Calcification may engulf the pineal. Demonstrates moderate homogeneous enhancement. Lobular lesion which may be hypointense compared to brain parenchyma, but higher than CSF. Hyperintense lobular lesion. Hyperintense lobular lesion. Areas of restricted diffusion within the lesion. Avidly enhancing mass.
Tectal Glioma Iso- or hypodense mass arising from the tectal plate. May demonstrate calcifications and cause aqueductal obstruction. (No image available.)   Demonstrates variable enhancement. Usually homogeneous. (No image available.)   Enlargement of the tectal plate. May result in compression of the aqueduct and hydrocephalus. Predominantely T2 hyperintense lesion. Hyperintense lesion.   May have minimal or no enhancement.
Pineal Cyst Hypodense cystic lesion in region of pineal gland. Rim enhancement. Ovoid lesion that is hypointense to white matter and close to CSF in signal intensity, with a thin intermediate signal-intensity rim. Ovoid lesion that is isointense to CSF with thin intermediate signal-intensity rim. Areas of moderately increased signal intensity. Typically does not restrict diffusion. Most commonly demonstrate rim enhancement, some may demonstrate peripheral, nodular enhancement.