Abstract: Objective To determine the correlation between image characteristics and pathology of pineal region tumors （PRTs）in adolescence.Methods The clinical data of the correlation between imaging findings and pathological types of 35 patients of PRTs in adolescence confirmed by postoperational pathological analysis were analyzed retrospectively.Results 35 patients with surgically and pathologically proved PRTs which comprised germinoma（n=19），pinealoma（n=6），astrocytoma（n=7）and others（n=3）.Germinoma lesions were isointensity or hypointensity on T1WI and slight hyperintensity on T2WI.Following enhanced scans，the tumors were obviously homogeneous enhancement.Additionally，the intratumoral calcification and tumor necrosis were often observed.Pineoblastoma lesions were hypointensity on T1WI and T2WI，obviously enhancement followed by enhanced scans.Tumor necrosis was often observed while intratumoral calcification was rare.Astrocytoma lesions were large in PRT with intratumoral cystic change but without intratumoral calcification and tumor necrosis.The tumors were isointensity on T1WI and T2WI.Following the enhanced scans，tumor cystic region were non-enhancement and tumor solid part were homogeneous enhancement.Conclusion Germinoma，astrocytoma and pineoblastoma were the most common pathological type of PRTs in adolescence.Due to the specific image features of different pathological tumors described above，we could make the preoperative qualitative diagnosis of PRTs accurately by analyzing the preoperational image data and the clinical features.

Key words: adolescence, pineal region tumor, imageology, pathology