Clinical question: Rathke's cleft cyst, evaluate for change. Signs and symptoms: Surveillance scan. Pre- and post enhanced pituitary MRI: Images are degraded due to motion artifact in particular on enhanced series.Within this limitation examination again demonstrate a mass with T1 hyperintense and T2 isointense signal intensity and with hypoenhancement on postinfusion series within the pituitary gland on the left and with mild extension across the midline to the right. The mass measures approximately 13 mm in transverse axis and an 7 mm in height which are measured on coronal post enhanced series. The overall appearance, signal intensity and size of this findings remains fairly similar to prior exam and without convincing evidence of change considering suboptimal post enhanced images.There is no evidence of extension of the lesion into the cavernous sinuses. The mass over slightly bulges into the basal cistern and is in contact with the suprasellar visual complex similar to prior exam. Pituitary stalk demonstrates normal size and enhancement similar to prior exam.Pre and post enhanced brain MRI:Negative diffusion weighted series.Examination demonstrate normal anatomical morphology and signal intensity of brain parenchyma on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.There is no detectable abnormal enhancement of brain parenchyma or the leptomeninges.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
1.Stable pituitary lesion suggestive of a Rathke's cleft cyst without evidence of change since prior exam.2.Unremarkable pre and post enhanced brain MRI.