Kaushal B.1, Chandrashekar H.M.2, Shobhalakshmi C.S.3, Vijakumar K.R.4
BACKGROUND
The sellar and juxtasellar region is a complex area where varied pathologies can
occur. Differentiation among various pathologies may not always be easy, since
many of these lesions mimic pituitary adenomas on clinical presentation,
endocrinologic and radiologic examinations. The study intends to describe the
imaging characteristics of the spectrum of pathological conditions affecting these
regions using magnetic resonance imaging (MRI).
METHODS
The main source of data for the study were patients from hospitals attached to
Bangalore Medical College and Research Institute, Bengaluru viz. Victoria Hospital,
Bowring and Lady Curzon Hospital and Vani Vilas Hospital. Patients with suspected
sellar and juxtasellar pathology on clinical examination referred to the Department
of Radiodiagnosis from November 2017 to May 2019 underwent MRI study using
Siemens 1.5-T Magnetom Avanto MR system. Magnetic resonance imaging was
done in all patients according to the pituitary protocol.
RESULTS
Among the 50 patients, there were 16 males and 34 females. Most of the patients
were in the third to fifth decade of life. The various abnormalities on MRI included
neoplastic (68 %), malformative (8 %), vascular (6 %), granulomatous, infectious
and inflammatory (18 %) lesions. Pituitary adenomas (46 %) were the most
common lesions in sellar and juxtasellar regions, followed by tuberculosis (10 %),
craniopharyngioma (8 %), Rathke's cleft cyst (6 %), meningioma (6 %), internal
carotid artery (ICA) aneurysm (4 %), epidermoid (2 %) and miscellaneous lesions.
CONCLUSIONS
MR imaging characteristics were sufficiently distinct to allow various sellar and
juxtasellar pathologies to be differentiated from each other. The spectrum of MRI
findings were related to neoplastic, malformative, infectious, inflammatory,
granulomatous and vascular causes. Our study observed that MRI with appropriate
imaging protocols is the essential imaging modality in evaluation of sellar and
juxtasellar lesions.
