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I want to talk about some miscellaneous structures on the

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midline sagittal MR that we frequently forget to look at.

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The pituitary gland is one of them.

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We've got the adenohypophysis or pars distalis

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and pars intermedia right there.

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The pars nervosa with a little bit of fat in the back,

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the pituitary stalk or pituitary infundibulum,

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and the median eminence,

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as it comes up and fans out a little bit.

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More importantly,

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structures that we frequently forget to look at,

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most of the time we don't forget to look at

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the pituitary gland, includes the superior sagittal sinus,

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which will frequently have in plain,

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slightly hyperintense wispy flow.

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But it shouldn't look like a big fat intermediate

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signal intensity gray worm.

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And I'm going to make it gray intentionally right now.

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You'll see how hard it is to see,

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because when it's gray and smooth

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and you've lost any flow phenomenon,

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it's going to blend with the adjacent gray brain,

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and you're going to completely miss it.

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So be on the lookout for an expansile solid,

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non-flow phenomenon area of gray signal

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throughout the superior sagittal sinus.

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This is absolutely critical not to miss.

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Anteriorly, you've got flow voids

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and implant flow phenomena in the

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basilar artery and in the basal plexus

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of vessels and/or veins.

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You've also got, anteriorly, the nasal cavity,

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the sphenoid sinus,

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and frontal sinus discussed previously.

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One structure that is frequently overlooked,

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especially in an adult, 50-year-old or 45-year-old,

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is the adenoidal pad.

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The adenoidal pad should be virtually nonexistent or flat.

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So when it's hypertrophy,

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you've got to consider things like Lymphoid hyperplasia,

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and even in certain circumstances, if asymmetric,

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nasopharyngeal carcinoma.

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Don't forget to look at the uvula,

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the opening of the oral pharynx, the base of the tongue.

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That's it from me.

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Pomeranz out.

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That concludes miscellaneous structures,

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you should take a look at on your sagittal midline scout.

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Pomeranz out.