 There is a 16 mm AP x 6 mm transverse x 6 mm craniocaudal cystic appearing focus involving the mesial right temporal lobe, lying just superior to the hippocampal formation. There is adjacent persistent FLAIR T2 hyperintensity.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There is no mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. Myelination is mature. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The mastoid air cells and middle ear cavities are clear. High-resolution images of the sella demonstrate the pituitary gland to be normal in size measuring for age. There is no discrete mass to confirm the presence of a pituitary microadenoma. There is no macroadenoma. The pituitary infundibulum inserts on the midline of the gland. There are no sellar, suprasellar or parasellar masses and the cavernous sinuses are symmetric bilaterally.
1.There is a 16 mm x 6 mm x 6 mm cystic appearing lesion involving the mesial right temporal lobe, lying just superior to the hippocampal formation, with adjacent persistent FLAIR T2 hyperintensity. The brain MRI portion of the exam was ordered without contrast, however the postcontrast pituitary study concurrently ordered demonstrates no enhancement of this anteriorly (although it is only partially imaged). The differential diagnosis most likely includes a postinflammatory cyst or perhaps low-grade cystic neoplasm. Given the persistent FLAIR hyperintensity, simple choroidal fissure cyst is not favored. Recommendations are made to obtain a follow-up exam in 3 months with contrast.2.Negative MRI of the sella including gadolinium enhancement.3.Findings were discussed with Dr. Patel (covering for Dr. Koren) on 9/28/2015 at 10:15 AM.