I had an MRI recently and i don’t understand what the radiology report means and the Internet is not being very helpful this time. here goes:

Findings: this is a focused examination of the pituitary gland, however axial t2, flair, t1, gradient and t1 post contrast images were obtained through the entire brain. additional dedicated sequences were obtained through the pituitary gland. these images show the ventricles and sulci to be appropriate for the patients age. no mass effect, hydrocephalus or abnormal extra axial fluid collections are seen. no cortical infarcts are seen. no focal white matter lesions are seen. no enhancing lesions are seen within the brain. there are no findings to suggest intractable hemorrhage. orbits are unremarkable. there is opacification of several ethmoidal air cells as well as mucosal thickening within the left maxillary sinus. flow voids are seen in the major cerebral arterial and venus vasclature. incidental note is made of few prominent vascular spaces within the brain stem and basal ganglia. craniocervical junction is within normal limits. marrow is visualized osseous structures is unremarkable.

dedicated images through the Sella were obtained. these show slight widening of the Sella with a thin rim of peripheral pituitary tissue. findings are consistent with a partially empty Sella which can be a normal variant. the infundibulum is midline. there is homogeneous enhancement to the pituitary gland. no Sella or suprasellar masses are seen. no adenoma of the pituitary gland is seen.

impression: 1) partially empty Sella with a thin rim of peripheral pituitary tissue identified. this can be a normal variant.
2) mild ethmoidal and left maxillary sinus disease.

this is my report, i understand nothing. please help me understand it.

Dr. Joshua’s Answer:

The sella is the location of the pituitary gland, which regulates the secretion of many key hormones in the human body. The radiology report in itself does not tell me very much - I’d need to know why the MRI was taken in the first place in order to evaluate the significance of the findings.

I can however give you a short summary in plain English: Your brain is normal. The sella, a bony pocket at the base of the brain, is slightly bigger than average, and it seems that most of the space inside the sella is empty, i.e. contains fluid (cerebrospinal fluid). The gland itself has been pushed to the rims of the sella by the pressure of the fluid. There are no indications of tumors anywhere, including the pituitary gland.

As an side finding, you seem to have sinusitis. Did you have a cold when the MRI was taken? If you have symptoms of sinusitis, fever, headache, persistent cold, talk to your primary care physician and he/she can prescribe a course of antibiotics if needed.

So, your MRI report means that you have empty sella. This brings us back to the reasons for the MRI. If the MRI was taken because your symptoms or hormone levels suggested there may be a disturbance in the function of your pituitary gland, then the finding is significant, and an endocrinologist needs to evaluate the need for treatment. Treatment is usually medical, and virtually never surgical.

If on the other hand you had no symptoms, or you had some unrelated symptoms that lead to a head MRI to be taken, and the sella-MRI was ordered because of the incidental finding of empty sella, then the finding is not significant and that’s why the radiologist has written down the words “normal variant” meaning normal, just a bit different from average.

Summa summarum: If you have no pituitary gland dysfunction, no symptoms, no hormonal imbalances, the MRI report means all is well. If you have further questions, I recommend that you talk to an endocrinologist.

In women, empty sella is sometimes associated with high blood pressure and obesity. Symptoms of pituitary gland dysfunction include cessation of menstrual periods, infertility, failure to lactate, decreased libido (sexual interest), fatigue, weakness, sensitivity to cold, decreased appetite, weight loss, abdominal pain, low blood pressure, headache, visual disturbances, short stature, loss of body hair.

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