Pituitary adenoma, syncopal episode, pacemaker/defibrillator, Cushing's disease. Evaluate change. Pre-and post-enhanced CT of pituitary:100 of Omnipaque 350 is administered for the post-infused portion of the exam.Contiguous axial 0.9-mm CT images of the entire brain before and after administration of contrast were obtained. Sagittal and coronal 2-D reformatted images were also rendered.This examination is tailored primarily for evaluation of pituitary gland.The nonfused exam demonstrates no evidence of any acute intracranial process. No evidence of hemorrhage, edema, mass-effect, midline shift or hydrocephalus is identified. Coronal and sagittal reformatted images demonstrate normal at hearing size of sella turcica and with primarily CSF density content. A very thin pituitary gland is identified. The pituitary stalk is also identified. There is no evidence of any abnormality in the basal cistern. The suprasellar visual complex is unremarkable.On post infused images there is no detectable abnormal enhancement the brain parenchyma or leptomeninges.Sagittal and coronal 0.9-mm 2-D reformatted images through the sella identifies very small thin pituitary gland with enhancement. Due to very small size of the gland precise measurement is not possible however but the best estimate the gland measures approximately 1.5 mm in cranial -- cephalad axis. On prior enhanced MRI of pituitary the heights of pituitary gland measured 3 mm.There is normal enhancement of midline pituitary stalk. There is subtle increase in the caliber of the pituitary far laterally on the left which measures approximately 3.9 x 4.9-mm in size. This may represent a pituitary microadenoma. There is no abnormality of basal cistern. The cavernous sinuses demonstrate no definitive abnormality. Sphenoid sinus is well pneumatized and unremarkable.Although not possible to precisely compare this CT exam with the prior pituitary MRI study the overall very small size of the pituitary gland is similar to prior exam. Prior MRI also demonstrates a focus of low attenuation on post infused images in the far left side of pituitary gland along its inferior aspect which measures 7.1 x 4.1-mm which is larger than current measurements of 3.9 times 4.9-mm..
1.Very small and thin (approximately 1.5 mm in thickness) and abnormal enhancement. The heights of pituitary on prior exam and measures approximately 3 mm in size. Pituitary stalk demonstrates normal enhancement and is in midline.2.Focal thickening of pituitary gland far laterally on the left measuring 4.9 x 3.9-mm in size compared to prior MRI measurements of 7.1 x 4.1-mm. This finding could represent a small pituitary microadenoma.3.Unremarkable exam otherwise.