Pituitary Adenoma with Ischemic Changes: MRI Report

Dear Sir, Below i am sending my father MRI report, kindly guide me. MRI REPORT – BRAIN WITH CONTRAST TECHNIQUE: T1W Sagittal, DWI - b1000, ADC, GRE T2W FS Axial, MR Angiogram, FLAIR Axial & Coronal Post contrast images after administration of 5 ml of gadolinium contrast. OBSERVATION: The study reveals an intrasellar mass lesion, with enlargement of the right half of the anterior pituitary gland, extending to the suprasellar cistern. The mass lesion is predominantly isointense to gray matter on T1-weighted images. On T2-weighted images the mass is predominantly isointense to gray matter with internal areas of T2 hyperintensity suggestive of ?necrosis/cystic change. Dynamic postcontrast images revealed decreased/delayed enhancement of the mass lesion as compared to the rest of the pituitary gland. The mass lesion measures 1.2 AP x 1.6 TR x 1.6 SI cm. Superiorly the mass displaces the infundibulum to the left side. A clear CSF plane of cleavage is seen between the superior aspect of the mass lesion and the optic chasm. No significant parasellar extension of the mass lesion is seen. The cavernous segment of both internal carotid arteries show normal flow void. The mass causes mild thinning of the floor of the sella turcica, with slight bulge toward the roof of the sphenoid sinus. MR findings likely represent pituitary adenoma. Confluent and discrete areas of T2/flair hyperintensity are seen in bilateral supratentorial periventricular and subcortical deep white matter, likely representing nonspecific ischemic changes with a combination of leukoariosis, microvascular ischemic changes, lacunar infarcts and prominent perivascular spaces. Basal ganglia and thalami are normal. Midbrain, pons and medulla are normal in signal intensity. The cerebellum appears normal. Bilateral CP angle cisterns are normal. The ventricular system and subarachnoid spaces are normal. No significant midline shift is seen. The cranio-cervical junction is normal. Post-contrast images reveal no other abnormal enhancing pathology. Bilateral maxillary sinus polyps are noted.