sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Kosalmn / M / 27 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

H/O operated for pituitary adenoma in 0000. Subsequently received Radiotherapy (41 sittings).
For follow up.
No complaints at present.

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.
MR Cisternogram was performed in the sagittal plane.
The brain was screened with 5 mm thick T2 Weighted axial images.

OBSERVATION :

There is ballooning of the floor of the sella. There is seen a multiseptate cystic lesion within the sella which is
the sequelae of the previous pituitary adenoma and subsequent surgery and radiotherapy. Minimal tissue along the sellar floor may represent pituitary tissue (it is however difficult to confirm this). The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images.

The pituitary stalk appears thickened with a probable calcific speck in that region. The suprasellar cistern and the left cavernous sinus are unremarkable. Slight extension of the cystic changes into the right cavernous sinus is noted with slight displacement of the cavernous segment of the right internal carotid artery, supero-laterally.


The T2 Weighted axial images of the brain reveal ill-defined hyperintense signal in the subcortical and deep white matter in the fronto-temporo-parietal regions bilaterally. Mild dilatation of both the lateral and the third ventricles is noted. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci bilaterally. There is no midline shift.

There is evidence of a right fronto-parietal craniotomy.

IMPRESSION :

1. Post-operative and post-radiotherapy status.

2. Multiseptate cystic lesion in the sella with widening of the sellar floor is the sequelae of previous pituitary macroadenoma with subsequent surgery and radiotherapy. The pituitary stalk is slightly thickened with a probable calcification in that region.

3. Altered signal in the subcortical and deep white matter in the fronto-temporo-parietal regions bilaterally most likely represent post-radiation changes, in the given clinical setting.