Presentation
Borderline elevated prolactin.
Patient Data
Technique:
Multiplanar, multisequence imaging has been obtained through the brain including post contrast dynamic images through the pituitary fossa.
Findings:
The pituitary is normal in size, signal, and dynamic contrast enhancement. Apparent hypodensity seen on the left side of the gland on sagittal imaging represents partial voluming of the most aspect of the internal carotid artery. The infundibulum is midline. Optic chiasm, cavernous sinuses, and suprasellar region appear unremarkable. The remainder of the imaged brain (please note this study has been targeted to the pituitary, and as such the whole brain has not been imaged) appears unremarkable.
Conclusion:
Normal examination.
The pituitary (red dotted line) has an anterior (P) and posterior (*) parts, as well as the infundibulum (I), into which projects the infundibular recess (IR) of the third ventricle. Note how close to the pituitary is the optic chiasm (green dotted line), above which is the supraoptic recess of the third ventricle. The mammillary bodies are posterior (yellow dotted line) separated from the infundibulum by a very thin membrane forming the floor of the third ventricle (the site for third ventriculostomy).
The pituitary fossa is bounded anteriorly and usually inferiorly (depending on the degree of pneumatization, by the sphenoid sinus, and posteriorly by the clivus.
The pituitary gland (red line) and infundibulum (I) are seen immediately below the optic chiasm (green line). On either side is the cavernous sinus (yellow line) containing the internal carotid artery (orange). Below the gland is the sphenoid sinus.
Case Discussion
This case demonstrates the normal anatomy and normal MRI appearance of the pituitary gland.
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