 This exam is degraded by motion artifact.Pituitary gland is overall normal in height without discrete mass appreciated. Centrally there is appearance of a partially empty sella. There is however thickened appearance of the pituitary tissue involving the peripheral aspect of the sella, anteriorly where it measures 4 mm in the AP dimension and 11 mm in height as well as posteriorly where it measures 4 mm in the AP dimension and 8 mm in height. Similarly there is prominence of the pituitary tissue involving the lateral aspects of the sella particularly on the left. There is a small defect involving the inferior aspect of the sella on the left with mild associated soft tissue extending inferiorly into the sphenoid sinus measuring approximately 4 mm. Combined the mildy hypoenhancing soft tissue in the left lateral aspect of the sella measures 14 x 11 mm in the craniocaudal and transverse dimensions.(coronal post gad image 6/18). No evidence of cavernous sinus invasion, suprasellar extension, or mass effect on the optic chiasm. The infundibulum is midline. The optic chiasm, cavernous sinuses and intracranial portions of the optic nerves are normal in appearance.There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are multiple unchanged punctate foci of T2 hyperintensity within the supratentorial and infratentorial white matter including the brainstem. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. There are bilateral lens implants. There is an apparent partially imaged unchanged expansile mass within the left hemi-maxilla.
1.Pituitary gland appears normal in height centrally with partially empty sella appearance. There is however prominence of the soft tissue in the peripheral aspects of the sella particularly anteriorly and the left lateral aspect of the sella where there is focal downward bowing/dehiscence of the left sellar floor and extension of 4 mm soft tissue into the left sphenoid sinus. Findings are favored to represent residual pituitary adenoma. Overall appearance is unchanged since 8/30/2013. No suprasellar extension or mass effect on the optic chiasm. Comparison with remote priors may be helpful if available.2.Unchanged mild to moderate chronic small vessel ischemic disease within the supratentorial and infratentorial white matter including the brainstem.3.Unchanged left hemi-maxilla expansile mass is compatible with the presumed fibro-osseous lesion as seen on CT neck.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.