Craniopharyngioma identification by CT and MR imaging at 1.5 T

To compare the detectability of craniopharyngiomas by CT and MR imaging, preoperative CT and MR studies obtained within 16 days of each other were evaluated retrospectively in 9 patients. MR imaging demonstrated cystic and solid tumor components in all 9 tumors, and enhancement in the 7 tumors that were studied after contrast medium injection. MR imaging demonstrated a signal void consistent with calcification in 4 patients. Combining unenhanced and contrast medium-enhanced studies, CT also identified all the tumors. CT demonstrated cysts in 7 lesions, calcification in 7 and enhancement in 6 of the 7 lesions that received i.v. contrast medium. Calcification was better seen by CT than MR imaging, while MR imaging identified cystic tumor components not seen on CT. The contrast medium enhancement pattern was the same with the 2 modalities. MR imaging of the sellar region, including at least one contrast medium-enhanced sequence, should be sufficient in most instances to establish a preoperative diagnosis of craniopharyngioma.