FIG 1. Sagittal MR images obtained in a 4-year-old boy with precocious puberty.

A, Sagittal contrast-enhanced T1-weighted MR image shows a 16 x 13 x 13 mm pineal cyst with enhancement of slightly thickened wall and focal wall irregularity (arrow).

B, 3D CISS imaging reveals a focal lobulation (arrow) and a nodule-like area (arrowhead) of the lesion. Although it is difficult to distinguish the lesion from a pineal cyst even on the CISS images, the morphological description of the lesion is atypical for a pineal cyst.