Suprasellar Lesions: Evaluation with MR Imaging

The authors retrospectively evaluated the characteristics on magnetic resonance (MR) images of 59 suprasellar lesions and compared them with computed tomography (CT) scans in 55 of the cases in which CT was performed. A diverse number of lesions were included: 17 pituitary adenomas; eight optic or hypothalamic gliomas; six craniopharyngiomas; six vascular anomalies; four lesions with extension into the suprasellar space; three metastases; two each of meningioma, hamartoma, germinoma, sarcoid granuloma, and teratoma; and one each of lymphoma, optic tract hematoma, cerebrospinal fluid-borne metastasis, pituitary hyperplasia, and sphenoid sinus mucocele. MR enabled characterization of lesions containing hemorrhage, fat, flowing blood, mucus, and cyst and allowed more specific diagnoses than CT in 6% of cases. MR was equivalent to CT in allowing lesions to be detected and in 20% of cases more accurately defined altered perisellar anatomy. Vascular abnormalities can be better evaluated with MR, and use of angiography can be avoided in some cases.