Role of mri in evaluation of sellar, parasellar and suprasellar lesion with histopathological correlation

Background: Anatomical complex areas seen in parasellar region includes e.g. orbits, cavernous sinus and its contents like ICA and the walls of the cavernous sinuses, suprasellar cistern, hypothalamus attach through the pituitary stalk and dural reflections forming diaphragm sellae. Wide diversity of anatomy and pathology includes tumors, cyst, vascular lesion, inflammation, infection and congenital lesions1. A number of diseases that affect the pituitary-hypothalamic axis can have profound clinical, endocrinological as well as neurological consequences. Aim of study was to evaluate MRI findings in Sellar, Parasellar and Suprasellar lesions and compare the results with histological findings and asses diagnostic accuracy of MRI in characterisation of these lesions. Methods: We reviewed the records of 50 patients strong clinical complaints suggestive of Sellar, Parasellar and suprasellar lesions or previous CT was showing abnormality, were evaluated. Radiological appearances were correlated with intraoperative findings and post-operative histopathology. Results: Majority (66%) of patients in study belonged to the third and fourth decade. Most common mass lesion was pituitary macroadenoma comprising about 66% of total cases. We observed a very good diagnostic accuracy of 100% in diagnosing pituitary macroadenoma. MR was 75% accurate in diagnosing craniopharyngioma. MR have 100% efficiency in diagnosing meningioma. Conclusion: MRI is the modality of choice for characterizing sellar and suprasellar lesions, morphology of lesions, nature of contrast material enhancement and extent of lesions. Hence MRI has very good diagnostic accuracy in characterisation of masses with good correlation to histopathology is the modality of choice for diagnosing sellar and suprasellar masses with high accuracy, sensitivity and specificity.