History of pituitary adenoma. Status post radiation treatment. Visual field defect. There are changes of previous transsphenoidal surgery. The contrast-enhancing sellar mass has increased in size since the previous examination, measuring craniocaudally 16 mm compared to 13 mm previously, while it otherwise remains unchanged measuring 21 mm anteroposteriorly and 15 mm in transverse. There is focal subtle relative T1 shortening in the left superior lateral aspect of the mass which correlates with poor contrast enhancement. This is new since the previous examination and may represent hemorrhage within the mass.The mass now abuts the right prechiasmatic optic nerve as it passes underneath the right A1 segment. The optic apparatus remains mildly deformed, with unchanged increased T2 signal abnormality within the right optic nerve. The pituitary infundibulum is displaced to the left and the mass only partially encases the horizontal cavernous segment of the right internal carotid artery by 180 degrees, which is unchanged.Limited images of the brain demonstrate no evidence of acute ischemia. There is perhaps very mild restriction in the area of the known adenoma. Scattered foci of T2 signal abnormality in the periventricular and subcortical white matter likely represent chronic small vessel ischemic disease given the patient's age. There is minimal mucosal thickening in the paranasal sinuses which is nonspecific.
1.Minimal increase in the size of the pituitary adenoma since March 2015 examination with increased upper margin convexity, now abutting the optic apparatus. This may, at least in part, relate to interval mild subacute hemorrhage within the mass as described above.2.Other post treatment findings remain unchanged.