ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzakala Slmn / F / 24 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness with drooping of the right eyelid since 1 month and diplopia.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
3 mm thick T1 Weighted and STIR coronal images through the optic pathway.
5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer.
3 mm thick T1 Weighted sagital and coronal images.

OBSERVATION :

The pituitary gland appears bulky with irregularity of the pituitary stalk which appears thickened. The normal hyperintense signal of the posterior pituitary gland is not visualized on this study. There is a central necrotic area within the pituitary gland which turns hyperintense on the T2 Weighted images. There is compression upon the cavernous sinus on either side, more marked on the right side. After administration of contrast, there is thick peripheral enhancement of the pituitary with a non-enhancing centre (? necrotic). The pituitary stalk also shows homogeneous enhancement. There is extension of the soft tissue into the cavernous sinus on the right side.




The cavernous portion of the internal carotid arteries on either side show normal flow void signal on all the pulse sequences.

The optic chaisma is not well-visualized separately from the lesion. The intraconal optic nerves show normal signal intensity on the STIR images.

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

IMPRESSION :

The MRI features are suggestive of an enlarged pituitary gland with central necrosis with thickening of the stalk and extension into the right cavernous sinus is not specific for a single etiology. Such features may be seen with Shehans syndrome (post-partum necrosis).