Reason: history brain mets s/p SRS to pituitary met please compare History: none Dedicated pituitary sequences were not again acquired on this exam. Images are somewhat limited by patient motion as well. Available imaging demonstrates there has been further slight interval decrease in the size of the previously seen slightly irregular mildly enhancing sellar/suprasellar mass. The lesion demonstrates diffuse T2 hypointensity which may relate to hemosiderin staining and/or mineralization. Postoperative changes from previous transphenoidal sellar surgery are again noted. The pituitary infundibulum and optic chiasm are better visualized than on previous exam, with relative hypoenhancement suggested to the left of midline along the upper margin of the pituitary gland.The ventricles and sulci are within normal limits for age. The cisterns remain patent. There is no midline shift or mass effect. There are no new areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The remainder of the midline structures and craniocervical junction are within normal limits. The patient's known left masseter mass visualized on coronal T1 postcontrast images, measuring 1.1 cm transverse by 1.5 similar CC. It is overall T1 hypointense with mild patchy enhancement as well as a more prominent halo of ill-defined enhancement surrounding it. Is not entirely included within the previous field-of-view on dedicated MR brain exams.
Exam limited due to lack of dedicated pituitary imaging as well as motion artifact. Further interval decrease in size of the sellar/suprasellar mass, with improved visualization of the suprasellar cistern, pituitary infundibulum, and optic chiasm.