D.D of Non Enhanced Hyper Intense Signal T1 Pituitary Lesion (MR).

PROTOCOL:

T1W – Sagittal & axial scans
T2W – Axial & coronal scans
FLAIR – Axial scans 

FINDINGS:

-Revealed:
• A sellar mass with 13 x 12 mm diameters with deviation of the stalk upward and anterior.
• T1 hyper intensity like that of fluid or fat with also bright signal on T2 and Flair images.
• No appreciable enhancement after contrast injection with compression of the enhanced pituitary gland.
• Right optic nerve sheath distension (6.8 mm) and tortuous if compared to the left one (4.8 mm) probably due to mass effect for clinical correlation.

-Brain Parenchyma shows normal grey white matter differentiation and signal intensities.  No focal mass lesion is seen.
-Lateral and third ventricles are normal in size and position. Septum is in midline.  There is no midline shift.
-Basal cisterns, cortical sulci and gyri are normal in appearance.
-Corpus callosum shows normal MR morphology.
-Brain stem and cerebellum show normal signal intensities.  
-Fourth ventricle is normal in size and is midline in position.
-Normal appearance of cervical cord.


OPINION:

• Picture is suggestive of a cystic versus fatty lesion of the sella tursica resulting in compression of right optic nerve sheath for clinical correlation.
• Fluid attenuated lesion with no enhancement as Rathke cleft cyst.
• Or fatty attenuation lesion with no enhancement as Hamartoma.
• The intense brightness of the lesion in T2 images gives more probability for Rathke cleft cyst rather than Hamartoma.




Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist
Report Status : Invalidated / Validated By :  Dr.Mohammed Mohyeldin