1. MRI CASE Done By: Haya Al-Thuwaini Ro’aa Al-Nemer Kholoud Al-Washmi Prepared For: Dr.Halima,,

2. Out lines: The procedure:  Pt history  Clinical indication.  About the disease.  Scanner &sequences.  Finding & images.

3. Procedure: MRI sella turcica. DOE: 9-AUG-2010 History: 33 years old female with headache associated with blurred vision. Clinical indication: R/O pituitary adenoma.

4. Pituitary Adenoma Pituitary adenomas are a noncancerous growth in the pituitary gland. * account for about 15% of intracranial neoplasm's. TYPES of Pituitary Adenomas: They are classified based on size: 1.Pituitary microadenomas are smaller than 10 millimeters (more common). 2.Pituitary macroadenomas are 10 millimeters or larger.

6. SYMPTOMS of Pituitary Adenomas: 1.Symptoms vary, depending on the size and location of the adenoma. 2.Tiredness, headaches, vision problems, vomiting, or dizziness. DIAGNOSES: 1.pituitary function testing (blood hormone levels). 2.pituitary imaging: computed tomography (CT), MRI scan is preferred.

7. TREATMENT for a pituitary adenoma can include: Depend on the type of tumor & its size: Surgery Radiation therapy. Drug therapy.

8. Scanner: GE (1.5 T) Sequence: FSE is:  a spin echo pulse sequence, but echo train length consists of several 180° rephasing pulses.  At each rephasing, an echo is produced and a different phase encoding step is performed.

9. Fast Spin Echo advantages: 1.Short scan time. Fast Spin Echo disadvantages: 1.higher SAR. 2.image blurring.

10. TECHNIQE: Multiplaner, multisequential MRI as per pituitary protocol including the following sequence: SAGITTAL T1 : TR = 650, TE = minimum, echo train = 3, BW = 15.6, F = 320, Q = 192, NEX = 4 SAGITTAL T1 FSE : The same as above. CORONAL & AXIAL DIFFUSION : TR = 10000, TE = min., F = 128, Q = 128, NEX = 2, P.value =1000 CORONAL T2: TR = 2075, TE = 120, echo train = 17, BW = 12, F = 320, Q = 224, NEX = 4 CORONAL T1 : TR = 450, TE = min., echo train = 2, BW = 15, F = 256, Q = 224, NEX = 4 CORONAL T1 FSE : The same as above.

14. Contrast media: 4 ml half dose. All sequences are taken pre + post CM except T2 sequence, it is only post CM. RF used coil: Head coil (volume coil).

15. Findings: The pituitary gland has normal size & signal intensity. Homogeneous enhancement with no focal pituitary lesion or abnormal enhancement. Impression: Unremarkable MRI pituitary gland examination.

16. THANK YOU,,