Pituitary microadenoma. Assess for changes. As discussed previously, the pituitary gland is elongated craniocaudally, measuring up to 12 mm, but is narrow in the transverse dimension. It also shows homogeneous normal signal on T1 and T2 sequences as well as appropriate homogenous contrast enhancement. The cavernous internal carotid arteries are medialized impinging on the sella, which is probably causing or at least contributing to the craniocaudal elongation of the pituitary gland. The pituitary infundibulum is midline and not thickened. There is no hypothalamic abnormality and the optic chiasm is unremarkable. There is no intrasellar acute infarct or hemorrhage nor in the included part of the brain.Included part of the brain shows nonspecific T2-hyperintense white-matter lesions which are unchanged and may reflect chronic microvascular ischemia.
The pituitary gland is elongated craniocaudally but is compressed in transverse by the cavernous internal carotid arteries. The gland continues to be homogeneous on all pre and post contrast sequences. Therefore, the increase in the craniocaudal dimension of the gland may reflect mere distortion of the gland by the mass-effect rather than the presence of a primary lesion such as an adenoma.