Clinical question: History of pituitary adenoma status post resection and RT. Signs and symptoms: Surveillance. Pre- and post enhanced pituitary MRI:Examination redemonstrate and expanded sella without interval change. Patchy ill-defined and very irregular residual enhancing soft tissue within the sella is again demonstrated and could represent a combination of residual pituitary tumor and postop changes. This enhancing tissue measures maximum of 7 mm intracranial cephalad access in the midline compared to prior study measurement of 7.4 mm. Pituitary stalk is difficult to identify atelectasis secondary to atrophy and postop changes which is also similar to prior study. There is no convincing evidence of abnormality of the cavernous sinuses. There is evidence of inferior herniation of the suprasellar visual complex similar to prior exam and likely as a result of treatment.Signal void of internal carotid arteries through the cavernous sinuses and in supraclinoid segments are identified and unremarkable.
1.Fairly stable very irregular and ill-defined residual enhancing tissue within the expanded sella as detailed/measured above. 2.Inferior herniation of suprasellar visual complex similar to prior exam and likely as a result of treatment.