CT and MRI of suprasellar lesions

The authors report their experience of CT and MRI imaging in the study of suprasellar pathologies. The problems concerning the differential diagnosis between meningioma developed in the suprasellar region and pituitary tumour with suprasellar extension are discussed and illustrated; the demonstration of bone abnormalities (blistering, hyperostosis) is particularly useful for the diagnosis of presellar meningioma. The CT and MRI features of craniopharyngioma are compared; CT, of course, is more reliable than MRI in detecting calcifications; with both methods it may be difficult to visualize the cystic components. Glioma of the chiasma is readily diagnosed by MRI, provided the tumour is not too large. Non-thrombosed suprasellar aneurysms have typical features at CT and MRI. Cystic lesions are easily identified by MRI. The CT and MRI images of inflammatory lesions are not very typical.