Date : 00.00.0000
Name of the Patient : Abc Xyzlmn / M / 61 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Sella & Perisellar Region.
CLINICAL PROFILE :
C/O ? acromegaly.
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 T1 Weighted sagittal images and 5 mm thick T2 Weighted axial images.
After administration of contrast the following parameters were used :
3 mm thick T1 Weighted coronal and sagittal images.
5 mm thick T1 Weighted axial images with magnetization transfer, through the brain.
There is seen an approximately 1.5 x 1.8 x 1.1 cms sized well-marginated, hypointense lesion on the T1 Weighted images in the anterior pituitary gland more to the left of the midline. This lesion appears slightly hyperintense on the T2 Weighted images. The pituitary stalk is displaced to the right. A rim of normal tissue is noted along the right lateral margin of the above described mass lesion. Probable extension of the lesion into the left cavernous sinus is noted. There is slight extension into the suprasellar cistern, without indentation on the optic chiasma. There is widening of the floor of sella.
The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The hypothalamus and the right cavernous sinus are unremarkable.
Screening images of the brain reveal an ill-defined hyperintense signal on the T2 Weighted images in the left frontal periventricular white matter, posterior parietal periventricular white matter bilaterally and in the subcortical white matter in the frontal and parietal regions bilaterally.
There is mild fullness of both the lateral ventricles. The third and fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no midline shift. The internal carotid arteries appears slightly ectatic.
Incidentally noted is a subgaleal lipoma in the suboccipital region in the midline and hypertrophy of the frontal sinuses.
After administration of contrast, the previously described lesion in the anterior pituitary gland does not show any significant enhancement. Enhancement of the normal pituitary gland along the right lateral margin of the lesion is noted.
There is no abnormal enhancement in the brain parenchyma per se.
1. An approximately 1.5 x 1.8 x 1.1 cms sized minimally enhancing mass lesion in the anterior pituitary gland more to the left of the midline as described, represents a pituitary macroadenoma.
2. Ischemic changes in the left frontal periventricular white matter, posterior parietal periventricular white matter bilaterally and in the subcortical white matter in the frontal and parietal regions bilaterally.