High Field (2.0T) MRI In Sellar and Juxtasellar Lesions

Abstract

We prospectively evaluated the magnetic resonance (MR) images of 28 sellar and juxtasellar lesions which were obtained using a 2.0T superconducting MR system and compared them with computed tomography (CT) scans. A variety of lesions were included: 14 pituitary adenomas; three germ cell tumors; two each of meningioma and empty sella; and one each of craniopharyngioma, teratoma, epidermoid, trigeminal neuroma, nasopharyngeal cancer with parasellar extension, tuberculoma and carotid cavernous fistula (CCF). MR more clearly demonstrated the relation of the lesions with the optic chiasm, infundibular stalk, carotid arteries, 3rd ventricle and cavernous sinus. Carotid and cavernous vascular structures were better evaluated with MR, and angiography may be avoided in some cases. MR enabled characterization of lesions containing hemorrhage, fat and flowing blood, and allowed more specific diagnoses than CT in hemorrhagic tumor and CCF. MR was equivalent to CT in detecting the lesions, even though most of the homogeneously enhancing tumors on CT including pituitary adenomas, meningiomas, germ cell tumors, tuberculoma, etc, revealed isointensity signal on MR. CT was more sensitive than MR for detecting calcification and sella- floor erosion.