Pituitary macroadenoma. There is an unchanged lesion in the right pituitary lobe that measures up to 14 mm in craniocaudal dimension, without evidence of mass effect upon the optic apparatus. There is disproportionate prominence of the third and lateral ventricles with a substantial CSF flow jet within the third ventricle. There appears to be a persistent rounded subcentimeter area of cerebrospinal fluid signal in the right anterior portion of the third ventricle that appears to be sharply demarcated from the cerebrospinal fluid flow artifact. In addition, there is disproportionate volume loss affecting the medial temporal lobes bilaterally. There is mild periventricular white matter T2 hyperintensity. The imaged portions of the sinonasal cavities are unremarkable.
1. Unchanged probable pituitary macroadenoma.2. Findings suggestive of Alzheimer's disease perhaps with superimposed normal pressure hydrocephalus.3. An apparent rounded subcentimeter area of CSF signal in the right anterior portion of the third ventricle that appears to be sharply demarcated from the CSF flow artifact, may be an artifact itself versus an arachnoid cyst or colloid cyst. If necessary, follow up with DRIVE or FIESTA sequences through this region may be useful for further elucidation.