The pituitary gland is enlarged and shows suprasellar extension. The gland is replaced by a lesion which is predominantly isointense on T1 with some peripheral areas of T1 hyperintensity corresponding with hyperdensity on CT. Heterogenous T2 signal, predominantly hyperintense with hypointense foci posterosuperiorly, correlating with T1 hyperintensity and consistent with blood product. Thin marginal enhancement but no solid, nodular or central enhancement. This lesion abuts the optic chiasm, which is displaced superiorly and is mildly flattened and splayed. The optic tracts demonstrate normal signal.
Conclusion: Recent haemorrhage into a cystic pituitary lesion, most likely a macroadenoma. In this clinical context, features are consistent with pituitary apoplexy.