Radiopathological correlation of sellar and suprasellar masses: our experience

Abstract

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.