sb/bv/nl/nl
/9 Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / F / 80 yrs.
Referred by : Dr. Abc Xyzrani / Dr. Abc Xyziwala.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O difficulty in swallowing since 20 days.
H/O right sided hemiparesis in May 0000. Recovered.
Previous MRI s/o lacunar infarcts.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
4 mm thick T2 Weighted, 5 mm thick FLAIR and 3 mm thick T1 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.

SOME IMAGES SHOW PATIENT MOTION AS PATIENT WAS COUGHING DURING EXAMINATION.

OBSERVATION :

There is seen an approximately 2.0 x 1.5 x 1.5 cms sized lobulated, sellar mass lesion extending into the suprasellar region. This lesion is of mixed signal with a solid and cystic component. There is indentation on the optic chiasma and proximal optic nerves which are displaced superiorly. There is no extension into the cavernous sinuses on either side. The posterior pituitary gland shows normal hyperintense signal on the T1 Weighted images. The anterior pituitary gland and the pituitary stalk are not well identified, separately.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally and in the right centrum semiovale. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.


A lacunar infarct is noted in the right centrum semiovale.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the maxillary antra bilaterally. Both eyes are aphakic.

IMPRESSION :

1. An approximately 2.0 x 1.5 x 1.5 cms sized lobulated, sellar mass lesion extending into the suprasellar region as described, most likely represents a pituitary macroadenoma.

2. Altered signal in the posterior parietal periventricular white matter bilaterally and in the right centrum semiovale most likely represent ischemic changes.