A right frontal burrhole is noted. Fat packing of the left sphenoid sinus implies previous trans-sphenoidal surgery also.
A 27 x 20 x 17 mm suprasellar mass lies between the optic chiasm superiorly and pituitary infundibulum inferiorly, compressing both structures. On this supine study, the anti-dependent 1/3 of the mass shows high T1 signal and low signal with fat suppression. The dependent 2/3 shows high T2/FLAIR and intermediate T1 signal. A fluid level is demonstrated between the two components. No diffusion restriction, magnetic susceptibility or post-contrast enhancement is appreciated.
The mass is clearly separate from the pituitary gland, which has normal appearances other than non-identification of the normal posterior pituitary bright spot.
Multiple small foci of high T1 signal are evident in the subarachnoid space of the supratentorial brain, most numerous in the frontal regions (ie anti-dependent). There is no hydrocephalus.