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sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Bholmn / F / 31 yrs.
Referred by : Dr. Abc Xyzgpal.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O primary amenorrhea.
Detected to have a pituitary microadenoma 1 1/2 years back.
C/O CSF rhinorrhea since 2 months.

EXAMINATION :

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

3 mm thick T1 Weighted sagittal and coronal images.

3 mm thick Fast Scan (T2 *) coronal images.

MR cisternogram was obtained in the coronal (supine and prone)and sagittal planes.

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

OBSERVATION :

There is still seen an approximately 8.0 x 10.0 x 15.0 mms sized intermediate signal intensity mass lesion on the T1 Weighted images in the right cavernous sinus inclose relation to the postero-inferior margin of the anterior pituitary gland on the right. This lesion appears relatively hypointense on the T2 Weighted images. Probable extension of the lesion into the sphenoid sinus along its right lateral margin is noted.

The rest of the pituitary gland appears normal in height and shows a concave superior margin.

The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in the
midline. The hypothalamus is unremarkable.
..2/.





The suprasellar cistern and the left cavernous sinus are unremarkable.

Minimal mucosal thickening is noted in the maxillary antra bilaterally. Minimal fluid is noted along the posterior wall of the sphenoid sinus. A small amount of fluid is also noted in the left lateral recess of the sphenoid sinus (scan 106.16).

There is no obvious outpouching of the meninges through a break in the floor of the anterior cranial fossa or the sphenoid sinus.
Review of the CT Scan dated 00.00.00, reveals thinning of the right lateral wall of the sphenoid sinus with probable erosion of the same and extension of the previously described lesion in the right cavernous sinus into the sphenoid sinus.

The T2 Weighted axial images of the brain do not reveal any significant feature of note, except for mild fullness of both the lateral ventricles.

IMPRESSION :

1. A residual pituitary adenoma in the right cavernous sinus inclose relation to the postero-inferior margin of the anterior pituitary gland on the right. Probable extension of the lesion into the sphenoid sinus along its right lateral margin is noted.

2. Minimal mucosal thickening in the maxillary antra bilaterally with minimal fluid along the posterior margin of the sphenoid sinus and in the left lateral recess of sphenoid sinus.

3. No definite meningeal outpouching is noted on this study, though extension of the lesion in the right cavernous sinus into the sphenoid sinus along its right lateral margin is noted.


















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