MRI findings in Parinaud's syndrome: a closer look at pineal masses. Neuroradiology 2019 May;61(5):507-514
Date
01/27/2019Pubmed ID
30684115DOI
10.1007/s00234-019-02166-4Scopus ID
2-s2.0-85060711126 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
PURPOSE: The association between MRI findings in patients with pineal lesions and the presence or absence of Parinaud's syndrome (PS) remains poorly described. We sought to better understand what MRI characteristics of a pineal lesion make PS more likely. Can these features predict prognosis for clinical resolution? Based on the anatomical relationship of the pineal gland and midbrain, we hypothesized that the degree of midbrain injury by a pineal mass as assessed by abutment, displacement, or intrinsic midbrain signal abnormality (IMSA) may predict PS.
METHODS: We reviewed our institution's databases to find patients with MRI evidence of an intrinsic lesion of the pineal gland. Seventy-seven patients with intrinsic pineal gland lesions, 26 with PS and 51 without PS (NPS), were identified. Data regarding clinical history were collected, and an experienced neuroradiologist reviewed all MRI studies and recorded mass size, midbrain abutment, displacement by the pineal lesion, and presence or absence of IMSA.
RESULTS: IMSA occurred with increased frequency in pineal lesions with PS (85%) when compared with NPS (39.2%) (p = 0.0001). Midbrain abutment, compression, and displacement occurred with similar frequencies in both groups, with no statistically significant difference. Hydrocephalus was present in 80.8% of patients with PS and 84% without PS (p = 0.75).
CONCLUSION: IMSA in a patient with an intrinsic pineal gland mass is associated with PS. Other findings such as hydrocephalus and midbrain displacement are common in patients with pineal masses both with and without PS and do not have any predictive value.
Author List
Vuppala AD, Hura N, Sahraian S, Beheshtian E, Miller NR, Yousem DMAuthor
Amrita-Amanda D. Vuppala MD Assistant Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Infant
Magnetic Resonance Imaging
Male
Middle Aged
Ocular Motility Disorders
Pineal Gland
Retrospective Studies
Sensitivity and Specificity
