Findings:
The pituitary fossa is smoothly expanded and remodeled by a heterogeneous mass, which extends into the suprasellar cistern. The mass elicits intrinsic height T1 signal and low signal intensity on the T2 sequence. It measures approximately 10 x 8 x 17 mm. The normal pituitary gland is not visible separate to the mass.
Superiorly, the mass elevates the diaphragma sella and optic chiasm and contacts the cisternal portion of the right optic nerve.
No invasion of the cavernous sinuses.
Mild to moderate involutional changes and chronic small vessel ischaemic disease is noted. There is no hydrocephalus or midline shift.
A small pineal cyst is seen.
Mucous retention cyst is seen in the right maxillary sinus. The orbits, paranasal sinuses and mastoid air cells are otherwise clear.
No bony abnormality is seen. Degenerative changes of the imaged upper cervical spine are seen.
Conclusion:
Appearance in keeping with pituitary macroadenoma with apoplexy.