Date : 00.00.00
Name of the Patient : Abc XyzPlmn / M / 67 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Sella & Perisellar Region.
CLINICAL PROFILE :
C/O sudden onset of loss of vision bilaterally since 4 days.
H/O fever since 6 days.
M.R.I of the sella and perisellar region was performed using the following parameters :
3 mm thick T1 Weighted and STIR coronal images.
5 mm thick T1 Weighted sagittal images.
The brain was screened with 5 mm thick T2 Weighted axial images.
There is a mass lesion in the region of the pituitary fossa which measures approximately 3.1 x 2.8 x 2.1 cms. This lesion shows mixed signal intensity with a predominant hyperintense signal on the T1 Weighted images which turns relatively hypointense on the T2 Weighted images with few hyperintense areas. There is extension of the lesion superiorly with indentation upon the optic nerves and the optic chiasma. Laterally there is indentation on the cavernous sinuses. The cavernous portion of the internal carotid arteries bilaterally show normal flow void signal on all the pulse sequences. Inferiorly the floor of the sella is ballooned with a suspicious break of the sellar floor anteriorly. The pituitary gland and the pituitary stalk cannot be identified separately from the lesion.
There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.
Incidental note is made of bilateral maxillary and ethmoidal sinusitis.
The MRI features are suggestive of a mass lesion in the region of the pituitary fossa measuring approximately 3.1 x 2.8 x 2.1 cms. with extensions as described. The differential diagnosis would include :
1. Pituitary macroadenoma with haemorrhage.