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FIG 4. Images from case 4.
A, Unenhanced midline sagittal spin-echo T1-weighted image (625/13/4) shows two brightly hyperintense foci: one involving the mammillary bodies and the other in the interpeduncular cistern (black arrowheads). There is also a smaller less hyperintense focus located at the expected site of the median eminence, suggestive of ectopic posterior pituitary lobe (white arrow). The pituitary gland and sella are small, with a suggestion of a tiny posteriorly angled infundibulum.
B, Unenhanced sagittal spin-echo T1-weighted image (650/9/2) with fat suppression, obtained at the same position as the image shown in A, shows suppression of the two larger more posteriorly located hyperintensities (black arrowheads), indicating that these represent lipomas. The smaller anterior hyperintensity of ectopic posterior pituitary lobe does not suppress (white arrow). A little flow-related artifact is seen in the floor of the third ventricle between the median eminence and the mammillary bodies.
C, Contrast-enhanced sagittal spin-echo T1-weighted image (650/9/2) with fat suppression shows enhancement of the median eminence, confirming that the anterior hyperintensity lies at a typical location for ectopic posterior pituitary lobe (short arrow). Enhancement of the infundibulum can also be seen (long arrow). The two lipomas remain suppressed, with no enhancement (arrowheads).
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