 Images are slightly limited by patient motion. Evaluation is somewhat limited due to differences in technique with regards to prior preoperative exams.Postoperative changes again seen from right frontal craniotomy. There is mild irregular enhancement along the right galea and adjacent musculature. The previously seen large heterogeneously enhancing mass within the sella and suprasellar region on the preoperative MRI is been largely resected. There is irregular intrinsic T1 hyperintensity within the expected location of the anterior superior aspect of the enlarged, with more conspicuous high signal along the adjacent sphenoid region with dropout of signal on fat saturated postcontrast images which may represent an area of fat packing with adjacent postoperative material along the surgical tract which is better delineated on coronal T2-weighted images. There is an area of irregular enhancement identified just anterior to the clivus along the inferior aspect of the enlarged sella, with additional superimposed lacelike enhancement of the area of intrinsic T1 hyperintensity in the expected anterior superior sellar location. Overall, the area of heterogeneous enhancement measures 1.6 cm transverse x 2.1 cm CC x 2.6 cm AP. Overall, the previous extensive mass effect appears resolved. The optic chiasm is now suggested but appears severely thinned. Optic nerves are at the edge of the field-of-view. Visualized flow-voids appear patent.
Postoperative changes following previous large sellar/suprasellar mass resection. Irregular enhancement remaining in the enlarged sella is nonspecific and may in part represent postoperative granulation tissue, although continued follow-up is recommended to evaluate for residual tumor. Overall, resolved extensive mass effect previously seen, with delineation of a very thin optic chiasm.