Figure 1
Axial T1 WI
Soft tissue localised posteroinferior to the splenium of the corpus callosum.
Enlarged isthmus of the cingulate gyrus
SectionNeuroradiology
Case TypeAnatomy and Functional Imaging
AuthorsAlejandro Rodriguez1, Yanet Torres
Connected authors
25 years, female
Clinical History
History of headaches.
Imaging Findings
MRI shows soft tissue, isointense with the signal of the brain tissue, localised in the posteromedial aspect of the right hemisphere, behind the thalamus and posteroinferior to the splenium of the corpus callosum, cross the midline, and protrudes into the supracerebellar cistern. No abnormal signal, enhancement or restricted diffusion (not shown) are detected.
Discussion
The cingulate gyrus is localised in the medial aspect of the brain hemisphere, its caudal aspect is called isthmus, it is behind and inferior to the thalamus and bellow the splenium of the corpus callosum [2].
Large cingulate gyrus is a rare variant. If present, it could be mistaken for a mass or tumour, in that case the absence of abnormal signal on Flair or abnormal enhancement could help in the correct diagnosis [1].
Four types are described, from the most common to the most unusual, as follows: normal presentation, prominent (does not reach the midline), very prominent (reaches the midline) and large (crosses the midline), the large type usually protrudes into the superior cerebellar cistern [1].
Large cingulate gyrus is a rare variant. If present, it could be mistaken for a mass or tumour, in that case the absence of abnormal signal on Flair or abnormal enhancement could help in the correct diagnosis [1].
Four types are described, from the most common to the most unusual, as follows: normal presentation, prominent (does not reach the midline), very prominent (reaches the midline) and large (crosses the midline), the large type usually protrudes into the superior cerebellar cistern [1].
Differential Diagnosis List
Large isthmus of the cingulate gyrus
Cingulate gyrus tumour
Cingulate cortex changes related to neurological diseases
Final Diagnosis
Large isthmus of the cingulate gyrus
References
[1] Sener RN. (1997) Large isthmus of the cingulate gyrus: an unusual anatomical variation simulating tumor. Comput Med Imaging Graph 21(6):337-9 (PMID: 9690006)
[2] Wang L, Hosakere M, Trein JC, Miller A, Ratnanather JT, Barch DM, Thompson PA, Qiu A, Gado MH, Miller MI, Csernansky JG. (2007) Abnormalities of Cingulate Gyrus Neuroanatomy in Schizophrenia. Schizophr Res 93(1-3):66-78. (PMID: 17433626)
Case information
| URL: | https://www.eurorad.org/case/15199 |
| DOI: | 10.1594/EURORAD/CASE.15199 |
| ISSN: | 1563-4086 |
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Axial T1 WI
Soft tissue localised posteroinferior to the splenium of the corpus callosum.
Department of Radiology. Clínica Ricardo Palma. Lima, Perú
Department of Radiology. Clínica Ricardo Palma. Lima, Perú
Axial FLAIR WI
No abnormal signal intensity is identified.
Department of Radiology. Clínica Ricardo Palma. Lima, Perú.
Department of Radiology. Clínica Ricardo Palma. Lima, Perú.
Axial T1 post-contrast WI
No abnormal enhancement.
Department of Radiology. Clínica Ricardo Palma. Lima, Perú.
Department of Radiology. Clínica Ricardo Palma. Lima, Perú.
