 Brain MRI:There are a few punctate foci of FLAIR hyperintensity within the bifrontal subcortical white matter, all of which correlate with apparent perivascular spaces on conventional T2 technique and are thus not felt to be clinically significant. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are essentially clear. Pituitary MRI:High-resolution images of the sella demonstrate the pituitary gland to be normal in size measuring 7 mm in height. There is a subtle focus of relative hypoenhancing heterogeneity within the posterior left paramedian pituitary without a discrete convincing focus to confirm pituitary microadenoma. There is no macroadenoma. The pituitary infundibulum inserts on the midline of the gland. There are no suprasellar or parasellar masses and the cavernous sinuses are symmetric bilaterally.
1.Negative noncontrast brain MRI.2.There is a subtle focus of relative hypoenhancing heterogeneity within the posterior left paramedian pituitary without a discrete convincing focus to confirm pituitary microadenoma. Please note that microadenomas may become heterogeneous or even indistinguishable if there has been pharmaceutical treatment.