Radiopathological correlation of sellar and suprasellar masses: our experience

Vikas Batra, Pankaj Kant Gupta, Ramanand Gehlot, Puneet Awasthi


Background: The area immediately around the pituitary, the sellar and parasellar region is an anatomically complex area that represents a crucial crossroads for important adjacent structures. A number of diseases that affect the pituitary-hypothalamic axis can have profound clinical, endocrinological as well as neurological consequences. Aim of the study was to identify the MR imaging characteristics of sellar and suprasellar masses, to correlate the MRI findings with histopathological findings and to calculate the diagnostic accuracy of MR imaging.

Methods: We reviewed the records of 116 patients with sellar and suprasellar masses for which preoperative MR imaging films or reports were available. Radiological appearances were correlated with intraoperative findings and post-operative histopathology.

Results: Majority of patients in this study belonged to the age group 21-40 years. Most common mass lesion operated was pituitary macroadenoma comprising 58% of the total cases. The accuracy, sensitivity and specificity of MRI in diagnosing macroadenomas are 86%, 88%, and 83% respectively. MR was 93% accurate, 85% sensitive and 95% specific in diagnosing craniopharyngioma. MR was 93% accurate, 80% sensitive and 95% specific in diagnosing meningioma.

Conclusions: MRI is the modality for characterizing sellar and suprasellar lesions, morphology of lesions, nature of contrast material enhancement and extent of lesions. Hence MRI is the modality of choice for diagnosing sellar and suprasellar masses with high accuracy, sensitivity and specificity.


MRI, Magnetic resonance imaging, Macroadenoma, Meningioma, Craniopharyngioma

Full Text:



Ruscalleda J. Imaging of parasellar lesions. European Radiology. 2005;15:549-59.

Banna M, Baker HL, Houser OW. Pituitary and parapituitary tumours on computed tomography. BJR. 1980;53:1123-43.

Lee BCP, Deck MDF. Sellar and juxtasellar lesion detection with MR. Radiology. 1985;157:143-7.

Johnson DE, Woodruff WW, Allen IS, Cera PJ, Funkbouser GR, Coleman LL. MR imaging of sellar and juxtasellar regions. Radiographics. 1991:11:727-58.

Taylor SL, Barakos JA, Harsh GR 4th, Wilson CB. Magnetic resonance imaging of tuberculum sellae meningiomas: preventing preoperative misdiagnosis as pituitary macroadenoma. Neurosurgery. 1992;31(4):621-7.

Donovan J, Nesbit M. Distinction of masses involving the sella and suprasellar space: specificity of imaging features. AJR. 1996;167(3):597.

Famini P, Maya MM, Melmed S. Pituitary magnetic resonance imaging for sellar and parasellar masses: ten-year experience in 2598 patients. J. Clin. Endocrinol. Metab. 2011;96(6):1633-41.

Van Effenterre R, Boch AL. Craniopharyngioma in adults and children: A study of 122 surgical cases. J Neurosurg. 2002;97(1):3-11.

Simmons GE, Suchnicki JE, Rak KM, Damiano TR. MR imaging of pituitary stalk: size, shape and enhancement pattern. AJR. 1992; 159:375-7.

Kumar J, Kumar A, Sharma R, Vashisht S. Magnetic Resonance imaging of sellar and superasellar pathology: A pictorial review. Curr Probl Diagn Radiol. 2007;36(6):227-36.