sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzathiralmn / F / 60 yrs.
Referred by : Dr. Abc Xyzhalani
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

Known C/O pituitary adenoma. Detected in 0000. Operated for same in November 0000 (transphenoidal excision was done). Received 36 sitting of radiotherapy.
Now C/O pain in both eyes (right more than left).

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.

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

OBSERVATION :

The pituitary gland is not well identified in the sella. In place is seen a well marginated, hypointense lesion on the T1 Weighted images which appear hyperintense on the T2 Weighted images. This may represent necrotic/fibrous tissue, the sequelae of previous excision of pituitary adenoma and subsequent radiotherapy. This lesion measures approximately 3.0 mms in height. The posterior pituitary gland is also not well identified. The pituitary stalk is in the midline. The optic chiasma and the left cavernous sinus are unremarkable.







There is seen an intermediate signal intensity lesion on the T1 Weighted images in the right cavernous sinus which appears relatively hypointense on the T1 Weighted images. There is loss of normal flow void signal of the cavernous segment of the right internal carotid artery.

There is no focal area of altered signal in the brain parenchyma per se. Mild fullness of both the lateral and third ventricles is noted. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and basal cisterns bilaterally. There is no midline shift. A mega cisterna magna is noted.

Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

1. Post-operative/post-radiotherapy status.

2. Changes in the signal intensity of the lesion in the sella may represent necrotic/fibrotic changes, the sequelae of previous surgery and subsequent radiotherapy.

3. Soft tissue lesion in the right cavernous sinus is not specific for a single etiology ? residual pituitary adenoma, ?? inflammatory tissue. There is resultant thrombosis of the cavernous segment of the right internal carotid artery.

As compared to the previous MRI dated 00.00.00, the pituitary gland now shows necrotic/fibrotic changes. The right cavernous sinus region is largely unchanged.