Clinical question: Central hypogonadism. Signs and symptoms: Central hypogonadism. Pre-and post-enhanced pituitary MRI:Examination demonstrates a well demarcated round nonenhancing lesion at the level of the pars intermedia of the pituitary gland measuring approximately 4 x 3.8-mm on coronal post enhanced images and 3 millimeters in AP axis on sagittal post enhanced series. The lesion is nearly isointense on T2-weighted images and is more suggestive of a small microadenoma however possibility of a cyst cannot be entirely excluded. There is no detectable mass effect with this finding and pituitary stalk remains in the midline.The maximum height of pituitary gland measures between 4.4 and 4.7 -mm on coronal and sagittal series and demonstrate uniform enhancement otherwise. Pituitary gland demonstrate normal signal intensity and normal pattern of enhancement.There is no detectable signal or morphological abnormality or the hypothalamic region.Bilateral cavernous sinuses demonstrate normal morphology, signal intensity and pattern of enhancement.Diffusion weighted images are negative. Flair, T2 and susceptibility MRI images demonstrate normal signal intensity brain parenchyma. There is prominence of lateral ventricles is noted. Post enhanced images are negative.Signal voids of major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are beginning normal and with normal pattern of enhancement.Unremarkable images through the orbits.Diffuse chronic sinusitis and well pneumatized bilateral mastoid air cells and middle ear cavities.
1.Pre-and post enhanced pituitary MRI demonstrate a well-demarcated approximately 4 mm nonenhancing lesion in the left paramedian. Finding is likely representing a small pituitary microadenoma. The less likely possibility of a cyst cannot be entirely excluded. Uniform pattern of enhancement of pituitary otherwise and with height measurements of 4.4 to 4.7-mm on coronal and sagittal post enhanced series.2.Unremarkable pre-and post enhanced brain MRI.