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Suprapineal recess

The suprapineal recess is a small, slit-like extension of the third ventricle in the brain, situated immediately above the pineal gland and below the splenium of the corpus callosum. This cerebrospinal fluid (CSF)-filled cavity is a normal anatomical feature and is best appreciated on brain imaging studies, particularly MRI. While not typically associated with pathological conditions, accurate identification of the suprapineal recess is important in the assessment of pineal region lesions and in the evaluation of the ventricular system.

SYNONYMS

  • Suprapineal cistern (sometimes used interchangeably, but not anatomically correct)

  • Pineal recess superior

  • Superior pineal recess

FUNCTION

  • Acts as a CSF-filled extension of the third ventricle above the pineal gland

  • Has no independent function; serves as part of the ventricular system facilitating CSF flow

  • Anatomical landmark for neuroimaging and neurosurgical procedures involving the pineal region

MRI APPEARANCE

  • T2-weighted images:

    • Appears as a small, hyperintense (bright) slit or cavity above the pineal gland due to CSF content

    • Borders may be sharply defined unless distorted by adjacent pathology

  • T1-weighted images:

    • Presents as a hypointense (dark) slit above the pineal gland

    • The CSF within the recess makes it distinguishable from the surrounding brain parenchyma

  • FLAIR images:

    • Appears hypointense (dark), similar to CSF in other ventricular regions

    • Useful for differentiating the recess from pathological lesions, which may have different signal characteristics

CT APPEARANCE

  • Appears as a small, CSF-density (hypodense) area above the pineal gland and below the splenium of the corpus callosum

  • Difficult to visualize unless the ventricles are dilated or there is adjacent pathology

  • May be outlined by calcified pineal gland inferiorly and the internal cerebral veins posteriorly

MRI images

Suprapineal recess mri 3t sagittal image