 Dedicated images through the sella demonstrate a nonenhancing teardrop shaped CSF signal intensity lesion within the left aspect of the pituitary gland, with associated osseous remodeling of the sella, corresponding to previous questioned abnormality. There appears be normal enhancing pituitary tissue superior to the margin of the cyst. Overall, size and contour appear similar to prior MRI of the spine from 2011. The cyst does abut the medial margin of the cavernous left internal carotid artery without encasement. The cyst measures 0.9 cm transverse x 1.0 cm AP centimeter AP x 0.9 cm CC.There is no other focal abnormal signal intensity or mass is seen within the enhancing pituitary tissue. The pituitary stalk essentially lies in the midline. Suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear unremarkable.Remainder of the visualized intracranial structures are grossly unremarkable. There is partial opacification of the left sphenoid sinus, similar to previous MR.
Likely incidental chronic finding of nonenhancing CSF signal intensity intrasellar cyst which involves the left aspect of the sella with associated bony remodeling and abutment of the cavernous left internal carotid artery. This is grossly unchanged since 2011. The pituitary tissue appears to have a claw sign around the cyst, and therefore this may represent a nonneoplastic pituitary cyst, less likely felt to relate to a cystic pituitary microadenoma. Given its location and T2 appearance, pars intermedia cyst is felt to be unlikely. There is no associated soft tissue nodularity to suggest craniopharyngioma.