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Date : 00.00.00

Name of the Patient : Abc Xyzh Shertlmn / M / 53 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O occasional headaches.
C/O giddiness with gait imbalance since 1 year.
Known diabetic/hypertensive.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images.

The brain was screened with 5 mm thick T2 Weighted axial images.

OBSERVATION :

There is ballooning of the sella turcica. There is seen a lobulated, intermediate signal intensity mass lesion on the T1 Weighted images with its epicentre in the sella and extending into the suprasellar region. This lesion appears heterogeneously hyperintense on the T2 Weighted images. A 7.0 mms diameter sized cystic/necrotic focus is noted within the lesion, antero-superiorly. The lesion measures approximately 2.8 x 2.7 x 3.6 cms.

There is extension of the lesion into the suprasellar cistern. The pituitary stalk is not well identified separately from the lesion. Indentation and superior displacement of the optic chiasma is identified. Probable extension of the lesion into the left cavernous sinus is noted. The cavernous segment of the left internal carotid artery however shows normal flow signal. There is thinning of the dorsum sellae and the floor of the pituitary fossa.
..2/.







The posterior pituitary gland and the right cavernous sinus are unremarkable. A vertically oriented septum is noted in the sphenoid sinus, nearly in the midline.

Screening T2 Weighted axial images of the brain reveal subtle hyperintense signal in the insular cortex bilaterally which may represent ischemic changes. Mild dilatation of both the lateral and third ventricles is noted. The fourth ventricle is normal.

IMPRESSION :

An approximately 2.8 x 2.7 x 3.6 cms. sized lobulated mass lesion in the sella extending into the suprasellar region and left cavernous sinus as described, most likely represents a pituitary macro-adenoma.




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