"Finally, the rest of the imaged brain should be reviewed for unexpected findings, and the report should indicate the the whole brain has not been assessed."
"diaphragma sella displacement: up vs. down"
"presence of florid sinus disease, nasal polyps, septal spurs, etc"
Expected headings
"Imaging protocol"
"Normal appearance on MRI"
"Age-dependent changes"
"Systematic approach to interpretation"
"Pituitary masses"
"Patterns"
"Helpful signs"
"What clinicians want to know"
"puberty: 10 mm (upper surface convex; more striking in females)"
"The optic nerves, optic chiasm, and optic tracts should be carefully assessed as even small lesions can lead to visual deficits. Extreme care should be taken in ensuring that there are no compressive lesions; a tiny meningioma within the optic canal can lead to significant compression and visual loss. The optic nerves should be followed as far anteriorly as possible on coronal T2 images (if obtained) to assess for the presence of increased signal within the nerve."
"The cavernous sinuses and Meckel caves should be examined for symmetry and normal anatomy. The visible arteries should all be inspected for obvious aneurysms or malformations; this is best done on T2 weighted imaging if provided. Although no dedicated arterial imaging is present, finding an asymptomatic aneurysm can be a life-saving event. In contrast, missing an obvious aneurysm which later ruptures is a tragedy. Particularly relevant regional aneurysms include anterior communicating artery aneurysms, medially projecting "carotid cave" aneurysm, superiorly projecting ophthalmic artery aneurysms, terminal internal carotid artery aneurysms, posterior communicating artery aneurysms and basilar tip aneurysms."
"It is also crucial to identify an aberrant course of the carotid or other aberrant vessels, especially if surgery is likely, and take into account the effect they are having on the pituitary glad; for example ectatic medially located cavernous carotid arteries (kissing carotids) can compress the gland and increase its vertical height mimicing an adenoma on sagittal images 5."
"As with all studies, having a systematic approach to the pituitary region is essential if subtle lesions are to be detected. There is no single correct way to do this, and what is presented is merely a personal approach."
"Assessment of pituitary masses is simplified by taking into consideration the overall pattern (both location, morphology and signal) as well as looking for specific signs."
"size of the bony sella, expanded or not, is useful, gives you an idea of the size of the surgical corridor"