Learning objectives
- To illustrate the imaging anatomy of the sella and its content.
- To illustrate a variety of lesions affecting the sella and their appearance on imaging,
using MR and CT techniques.
Background
Imaging anatomy of the sella and its content:
The sellar turcica is a saddle-shaped depression in the sphenoid bone.
It forms the caudal border of the pituitary gland.
This region contains critical neurovascular structures that directly cause disease processes or that are involved in the pathology as a result of the compact surroundings.
The area is bounded by sphenoid sinus anteroinferorly,
the paired cavernous sinuses laterally,
the suprasellar cistern and its contents,
diaphragma sellae and hypothalamus superiorly,
and the dorsum sella and brainstem posteriorly.[1]
Advances...
Findings and procedure details
In order to analyze a sellar or parasellar mass on MRI,
the following anatomic approach could be used[4]:
1. First identify the pituitary gland and sella turcica.
2. Then determine the epicenter of the lesion and whether it is in the sella or above,
below or lateral to the sella.
3. If it is in the sella,
determine whether or not the sella is enlarged.
4. Once the location of the mass is clear,
analyze the signal intensity patterns: is the lesion cystic or solid?...
Conclusion
MRI is the imaging method of choice in the exploration of the pituitary region.
It allows the diagnosis,
the follow up and the management of all pituitary pathologies.
References
1. Elster AD.
Imaging of the sella: Anatomy and pathology.Semin Ultrasound CT MR.1993;14:182–94.[PubMed]
2. Imaging sellar and suprasellar pathology
ByLubdha M.
Shah,
MD,
and C.
Douglas Phillips,
MD,
FACR
3. Osborn A,
Blaser S,
Salzman K.
Sella and Pituitary.
In:Diagnostic Imaging: Brain.Salt Lake City,UT:Amirsys,
2004.
4. Anatomic approach to differential diagnosis :Sellar and parasellar tumors.
Radiology Assistant website,
Neuroradiology.
5. Role of MRI in evaluation of various Sellar and Para-sellar pathologies.
V.
N.
Bakare,
K.
Taori,
A.
Disawal,
J.
Rathod,
S.
S.DHAKATE,
P.
S.
Wavare,...