Learning objectives
To provide a comprehensive review of anatomical landmarks of sellar and juxtasellar region.
To revise common and uncommon conditions in this complex anatomic region.
To highlight the imaging clues for their accurate diagnosis.
Background
Sella turcica is a shallow depression in the posterior sphenoid bone with the diafragma sellar above.
Adenohypophysis communicates with hypothalamic cells through a portal venous system and it contains five principal histologically cell types.
There is a wide variety of tumours and tumour-like conditions that affect this region in paediatric population,
which are different from those observed in adulthood.
Symptoms of these conditions often overlap,
so imaging tests,
specially MRI,
are clue to the final diagnosis.
Findings and procedure details
Sellar region is a complex anatomical space with several structures from different embryological origin (Fig. 1,Fig. 2)
Normal size and shape of pituitary gland depends on the age.
It is 6 mm with upper surface flat or slightly concave in children under 12 years-old and 10 mm with upper surface convex in puberty.
It should be homogeneously isointense on T1WI with a posterior “bright spot” representing neurohypophysis.
Pituitary stalk and neurohypophysis enhance before (20 seconds) than adenohypophysis (80 seconds)
Pathologies can be classified according to...
Conclusion
Anatomical characteristics of sellar region are complex and magnetic resonance is the modality of choice for their assessment.
Radiologists should be able to recognize the key radiological features of the conditions ofthisregion,
so they can help the clinicians in their diagnosis and management.
Personal information
José Miguel Escudero-Fernández
Department of pediatric radiology
Hospital Universitari Materno-Infantil Vall d’Hebron,
Institut català de la Salut.
Passeig de la Vall d’Hebron 119-129 08035 Barcelona Spain
Email:
[email protected]
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