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Pineal cyst and Rathke cleft cyst

Findings:
A small sharply demarcated cystic lesion in the pineal region, measuring approximately 8.5 x 5 mm and showing smooth peripheral enhancement, unchanged to the previous study. No interval changes, no mass effect or hydrocephalus.
Also, unchanged, small cystic lesion is seen located in the midline of the adenohypophysis, measuring 5 x 4 mm. It does not affect to the optic chiasm.
The ventricles and sulcal spaces are within normal limits. There is no midline shift.
The brain parenchyma is unremarkable. No abnormal signal on the susceptibility-weighted images or diffusion/ADC images is identified.
The intracranial circulation is unremarkable.
The orbits, paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction is normal.

Conclusion:
Stable appearance of the known small pineal cyst without evidence of any haemorrhage, mass effect or hydrocephalus.
Unchanged, cystic lesion of the pituitary gland, likely in keeping with Rathke cleft cyst. Further evaluation with MRI of pituitary gland is advised.

Updated on 3. May 2023

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About the author

Dr Sara Mohebbi is a Consultant Radiologist (Facharzt für Radiologie) with sub-specialty training in neuroradiology. She served as Chief Resident at University Hospital Freiburg and is a member of the European Society of Radiology (ESR). Her clinical focus includes demyelinating disease, neuro-oncology, and vascular neuroimaging. Dr Mohebbi is the Clinical Lead at Radiology Prime, where she provides independent second opinion reports on brain and spine MRI.