 There is a well marginated ovoid shaped pineal gland sized about 5.5mm x 7.2mm on sagittal plane with internal small T2 hyperintensities. This is likely normal pineal gland but may represent small internal pineal cysts. If clinically indicated, follow up MRI with Gad enhancement can be considered.There is a punctate nonspecific T2/FLAIR hyperintensity in the right lower centrum semiovale. There are no diffusion restriction or susceptibility abnormalities. There is no evidence of low-lying cerebellar tonsils. Ventricular size is normal. There is no midline shift. Vascular flow voids are unremarkable.CSF Flow study using phase contrast MRA over the foramen magnum demonstrates bidirectional flow through the foramen magnum without showing evidence of flow restriction.There is small round T2 isointense lesion in the lateral aspect of the left sphenoid sinus, most representing mucosal retention cyst.
1. Normal pineal gland with internal small T2 high signal intensities indicating possible internal small pineal gland cysts. Follow up MRI can be considered with Gad enhancement if clinically indicated. 2. No evidence of Chiari malformation.3. CSF Flow study demonstrates bidirectional flow over the foramen magnum.4. Mucous retention cyst in the left sphenoid sinus.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.