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Fig 1. A–D, MR images from 16-year-old boy who presented with a long-standing history of poor growth, delayed puberty, polydipsia, and polyuria.
A, Transverse T2-weighted image at the level of the cavernous sinuses shows an isointense mass involving the sella turcica, posterior sphenoid sinus, left greater than right cavernous sinus, the left middle cranial fossa, and the prepontine cistern.
B, FLAIR-weighted image at the level of the cavernous sinuses shows an isointense mass involving the sella turcica, posterior sphenoid sinus, left greater than right cavernous sinus, the left middle cranial fossa, and the prepontine cistern.
C, Midline sagittal T1-weighted image shows an isointense mass involving the basiocciput portion of the clivus, the sella turcica, the sphenoid sinus (short arrow), and the suprasellar cistern. The expected hypointense posterior cortex is absent (long arrow).
D, Midline sagittal contrast-enhanced T1-weighted image shows a heterogeneously enhancing mass involving the basiocciput portion of the clivus, the sella turcica, the sphenoid sinus, the suprasellar cistern, and the hypothalamus.
E, Coronal contrast-enhanced T1-weighted image at the level of the sella shows a heterogeneously enhancing mass involving the basiocciput portion of the clivus, the sella turcica, the sphenoid sinus, the suprasellar cistern, and the hypothalamus. There is extension into the left greater than the right cavernous sinus with encasement and stenosis of the left internal carotid artery. The typical hypointense cortex of the floor of the sella is not visible. The mass appears to abut the nasopharynx.
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