Pituitary and Sellar Region Lesions

Lesions of the sellar, parasellar, and suprasellar regions are common and account for up to 20% of all intracranial neoplasms. Of these, pituitary adenomas are the most common in adults, accounting for over 50% of all lesions in this region. Magnetic resonance imaging has become the imaging examination of choice in this region given its multiplanar capabilities, superior soft-tissue contrast and resolution, and lack of beam hardening artifact seen with computed tomography. The other imaging modalities play a more limited role in answering specific questions related to the lesions. Although there is considerable overlap in the imaging characteristics of the many lesions that can occur in this region, we will attempt to identify imaging characteristics of the lesions that are classic and allow for a more accurate preoperative diagnosis. The type, location, and extent of the lesion are important factors in determining the optimal surgical approach and in effective treatment planning.