Pituitary Macro adenoma (MR).

T1 sagittal pituitary image at the level of corpus callosum / shows balloning of sella tursica with a large pituitary macro adenoma reaching up to hypo thalamus and indentation inferior border of third ventricle.

T2 coronal pituitary image / shows the same findings as in the above image.

T2 sagittal pituitary image at the level of corpus callosum / shows the same finding as in the above images.

PROTOCOL:
Thin 3 mm T1W Sagittal & Coronal scans (Pre and post gadolinium contrast) for sella
T2W coronal scans for sella
T1W & T2W axial sections for brain
FLAIR coronal scans for brain

FINDINGS:

-Evidence of marked pituitary gland enlargement (39 mm height x 27 mm AP x 24 mm transverse diameters) causing expansion of the sella tursica with supra sellar extension reaching up to hypothalamus and floor of third ventricle in addition to the left  para sellar region.
-It causes wide depression of the roof of the sphenoid sinus.
-Complete obscuration of the optic chiasm and pituitary infundibulum is noted.
-Its surrounds the intra cavernous left carotid artery from the right and upper side; yet no definite abnormal tissue could be seen in its left side giving radiological impression of non invasion of the sinus. Increased laboratory hormonal level by more than 1000 ml is diagnostic for sinus invasion.

-Right para sellar structure shows normal MR morphology and signal intensity.
-Brain parenchyma shows normal grey white matter differentiation.
-Ventricles are normal in position and size.
-Brain stem and cerebellum are normal in appearance.


OPINION

• Picture is suggestive of pituitary macroadenoma for clinical correlation.
• Laboratory correlation is essential to exclude left cavernous sinus invasion.

For more details about the lesion click this link.